Reserevelations, LLC

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

RESEREVELATIONS, LLC

Doing business as

RRc3 Multilevel Firm, Inc

Practice address

31 S Main St
Dayton, OH 45402-2070

Phone

(937) 860-1038

Fax

(270) 203-0587

NPI assigned

Dec 14, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. De'Rese Zyire Gooden, NCC, LCMHC, CCHTNPI 1265957914

Title

Ceo, Owner & Director

Phone

(937) 860-1038

Specialties & licenses 8

Addresses

Other identifiers 1

Other names 2

• RRc3 Multilevel Firm, Inc Doing business as
• MKC Reality, Inc Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• De'Rese Zyire Gooden, NCC, LCMHC, CCHT

  • Prevention Professional
  • Dayton, OH
  • NPI 1265957914
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736035200000",
    "number": "1083326706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022070",
            "telephone_number": "937-860-1038",
            "fax_number": "270-203-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022070",
            "telephone_number": "937-860-1038",
            "fax_number": "270-203-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESEREVELATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A",
        "authorized_official_last_name": "GOODEN",
        "authorized_official_first_name": "DE'RESE",
        "authorized_official_middle_name": "ZYIRE",
        "authorized_official_title_or_position": "CEO, OWNER & DIRECTOR",
        "authorized_official_telephone_number": "937-860-1038",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NCC, LCMHC, CCHT"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0307155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RRc3 Multilevel Firm, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MKC Reality, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Voluntary or Charitable Agency in Dayton, OH
• Providers in Dayton, OH by specialty
• Voluntary or Charitable Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.