Revolution Wellness LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

REVOLUTION WELLNESS LLC

Practice address

455 Grandview Ave
Hubbard, OH 44425-2218

Phone

(330) 307-4396

NPI assigned

May 2, 2013

Organization subpart

No

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

Authorized official

Name

Mr. George Delano Summers III, MS ED

Title

Owner

Phone

(330) 307-4396

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1407291545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 GRANDVIEW AVE",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252218",
            "telephone_number": "330-307-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 GRANDVIEW AVE",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252218",
            "telephone_number": "330-307-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DELANO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-307-4396",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MS ED"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Hubbard, OH
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• Case Management Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.