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Organization
REVITALIZE PSYCHIATRIC SERVICES II, INC.
Active
Organization
REVITALIZE PSYCHIATRIC SERVICES II, INC.
Active
Other names
Revitalize Psychiatric Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LYNN HUFFMAN DNP, ARNP, PMHNP-BC (CEO)
(815) 212-1478
Entity
Organization
Contact information
Practice address
27524 CASHFORD CIR STE 102, WESLEY CHAPEL, FL 33544-6947
(815) 212-1478
(813) 906-7789
Mailing address
11919 CASTINE ST, NEW PORT RICHEY, FL 34654-1807
(815) 212-1478
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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