Revitalize Mental Health Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVITALIZE MENTAL HEALTH CENTER LLC

Practice address

307 S Eaton St Ste B
Baltimore, MD 21224-2525

Phone

(443) 354-2162

Fax

(443) 354-2162

NPI assigned

Aug 11, 2026

Organization subpart

No

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

Authorized official

Name

Tasha Nicole Outlaw

Title

Ceo

Phone

(443) 354-2162

Specialties & licenses 1

Addresses

Tax ID family

Revitalize Mental Health Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Revitalize Mental Health Center LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1376287557
  NPD tax ID

Locations

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

{
    "created_epoch": "1786406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1316862154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EATON ST STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242525",
            "fax_number": "443-354-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S EATON ST STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242525",
            "telephone_number": "443-354-2162",
            "fax_number": "443-354-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE MENTAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "OUTLAW",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-354-2162"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Reuss, PMHNP-BC, AGAC-NP
• Jameson Patrick Reuter, PHARM.D., BCPS
• Adrienne Reveal
• Gabriel Alexis Revelo
• Irene Francis Reville, L.C.S.W.-C
• Revitalize Mental Health Center LLC
• Revitalize Support Services, LLC
• Lori Beth Revitz, LCSW-C
• Revolution Rehabilitation and Sports Perforamance LLC
• Reward Health Services, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.