Revival Health Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

REVIVAL HEALTH HOME CARE LLC

Practice address

1129 Glenn St
Lansing, MI 48915-2115

Phone

(347) 605-0410

NPI assigned

Jul 25, 2024

Organization subpart

No

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

Authorized official

Name

Bolivar Altamirano

Title

Mr.

Phone

(347) 605-0410

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1821826207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2-06 ASTORIA BLVD",
            "address_2": "2E",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "347-605-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 GLENN ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489152115",
            "telephone_number": "347-605-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85004",
            "country_code": "US",
            "telephone_number": "347-605-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVAL HEALTH HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "ALTAMIRANO",
        "authorized_official_first_name": "BOLIVAR",
        "authorized_official_title_or_position": "MR.",
        "authorized_official_telephone_number": "347-605-0410"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Alexandria Rethmeyer
• Shalom Reuben, DDS
• Allison Landis Revels, LMSW
• Reverence Home Health & Hospice, LLC (Ascension at Home)
• John Kennedy Revis, DDS
• Rafael J Reyes, DPT
• Leslie K Reynolds, MD
• Nadine Reynolds
• Richard A Reynolds, D.D.S.
• Sara Reynolds

• In Home Supportive Care Agency in Lansing, MI
• Providers in Lansing, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.