Revive Rehab Center II LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVIVE REHAB CENTER II LLC

Practice address

20311 Mack Ave Ste 1
Grosse Pointe Woods, MI 48236-1784

Phone

(313) 469-8890

Fax

(313) 469-6971

NPI assigned

Jun 14, 2017

Organization subpart

No

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

Authorized official

Name

Angie Bazzi

Title

Owner

Phone

(313) 469-8890

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467982330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20311 MACK AVE STE 1",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361784",
            "telephone_number": "313-469-8890",
            "fax_number": "313-469-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 MACK AVE STE 1",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361784",
            "telephone_number": "313-469-8890",
            "fax_number": "313-469-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE REHAB CENTER II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAZZI",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-469-8890"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Reid
• Sandra Hollerbach Reid
• Rely Billing Solutions (Rely Home Healthcare)
• Renee C. Miller DDS PLLC
• Return to Balance, LLC
• Kathryn Reynolds
• Alice Rhein
• John Joseph Ricci, D.D.S.
• Richard S Fine MD PC
• Ariyon Richardson

• Physical Therapy Clinic/Center in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.