# REVITA HEALTHCARE, LLC

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

## Provider details

- **NPI number:** 1093066045
- **Authorized official:** MRS. CONSUELO LAGASCA DUMAYAS (ADMINISTRATOR)
- **Authorized official phone:** (847) 380-6253

## Contact information

- **Practice address:** 120 W GOLF RD STE 210, SCHAUMBURG, IL 60195-5161
- **Practice address phone:** (847) 380-6253
- **Practice address fax:** (847) 947-2786
- **Mailing address:** 120 W GOLF RD STE 210, SCHAUMBURG, IL 60195-5161
- **Mailing address phone:** (847) 380-6253
- **Mailing address fax:** (847) 947-2786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1011579 | IL | Yes |

## Other

- **Enumeration date:** 09/29/2012
- **Last updated:** 09/29/2012