Revitalize Healthcare, Inc

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

REVITALIZE HEALTHCARE, INC

Practice address

657 Lone Oak Rd Ste 2
Paducah, KY 42003-4547

Phone

(270) 556-1630

NPI assigned

Mar 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Henry D Babenco, MD

Title

Ceo

Phone

(270) 556-1630

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1972007128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 LONE OAK RD STE 2",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034547",
            "telephone_number": "270-556-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 LONE OAK RD STE 2",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034547",
            "telephone_number": "270-556-1630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803A Country Club Ln",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422401370",
            "country_code": "US",
            "telephone_number": "270-556-1630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVITALIZE HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "BABENCO",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-556-1630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilient RX LLC
• Respiratory Disease Clinic
• John Randall Resser, M.D.
• Restoration Physical Therapy LLC
• Restorative Family Medicine
• Amanda Diamantina Reyes-Gill, FNP-C
• Laura Reynolds, OT
• Mary Nguyen Reynolds, CRNA
• RH Emergency Medicine of Paducah LLC
• RH Hospitalist Medicine of Paducah LLC

• Addiction Medicine (Psychiatry & Neurology) Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.