# REVITALIZE HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083210314
- **Authorized official:** MIRIAM D HUGHES WHNP-BC, CNM (PRIMARY MEMBER)
- **Authorized official phone:** (719) 695-0756

## Contact information

- **Practice address:** 13535 MORNING SKY CT, PEYTON, CO 80831-8392
- **Practice address phone:** (719) 695-0756
- **Mailing address:** 13535 MORNING SKY CT, PEYTON, CO 80831-8392
- **Mailing address phone:** (719) 695-0756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/10/2020
- **Last updated:** 02/04/2021