Revitacare Health Centers

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REVITACARE HEALTH CENTERS

Practice address

1951 Stella Lake St Ste 26
Las Vegas, NV 89106-2144

Phone

(702) 366-4674

NPI assigned

Oct 10, 2024

Organization subpart

No

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

Authorized official

Name

Myiesha Armstrong-Dunmore

Title

Owner

Phone

(702) 366-4674

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1548080005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S TOWN CENTER DR APT 2134",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 STELLA LAKE ST STE 26",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062144",
            "telephone_number": "702-366-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITACARE HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG-DUNMORE",
        "authorized_official_first_name": "MYIESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-366-4674"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dasani Revels
• Revenue Care LLC
• Efrain Alejandro Reveron Lopez
• Alessandra Diana Reviglio, DMD
• Arianne Revilla, COTA
• Revive Behavior Health LLC
• Revive Crisis Clinic LLC
• Revive Injury & Wellness
• Revive Medical Center LLC
• Revive Therapy Health and Wellness Services LLC

• Mental Health Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.