# REVITALIZE PSYCHIATRIC SERVICES II, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Revitalize Psychiatric Services, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134995426
- **Authorized official:** KELLY LYNN HUFFMAN DNP, ARNP, PMHNP-BC (CEO)
- **Authorized official phone:** (815) 212-1478

## Contact information

- **Practice address:** 27524 CASHFORD CIR STE 102, WESLEY CHAPEL, FL 33544-6947
- **Practice address phone:** (815) 212-1478
- **Practice address fax:** (813) 906-7789
- **Mailing address:** 11919 CASTINE ST, NEW PORT RICHEY, FL 34654-1807
- **Mailing address phone:** (815) 212-1478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/28/2023
- **Last updated:** 11/28/2023