Navale Revolution Living

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

NAVALE REVOLUTION LIVING

Doing business as

NaVale Revolution Living

Practice address

10434 Executive Lake Dr
Stafford, TX 77477-3613

Phone

(713) 859-1089

NPI assigned

Oct 22, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Rhonda WynnNPI 1235399569

Title

Founder/Ceo

Phone

(713) 859-1089

Specialties & licenses 1

Addresses

Other names 1

• NaVale Revolution Living Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rhonda Renee Wynn, LVN

  • Licensed Vocational Nurse
  • Stafford, TX
  • NPI 1235399569
  NPD Authorized official

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1902627870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10434 EXECUTIVE LAKE DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773613",
            "telephone_number": "713-859-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10434 EXECUTIVE LAKE DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773613",
            "telephone_number": "713-859-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVALE REVOLUTION LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "713-859-1089",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NaVale Revolution Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NaVale Revolution Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Nangoh
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• Michelle Marie Nava
• Reyna Navarro, RN
• Mona Y Nawar, RPH
• Farzana Nazarali
• Wendy Ndionu Frazer, APRN- CNM
• Joan Elong Ndoke, RN

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Stafford, TX
• Providers in Stafford, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.