# REVIVAL HOME HEALTH CARE AGENCY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Revival Home Health Care Agency Inc, Revival Homecare Agency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659577724
- **Authorized official:** DR. AKRAM ELZEND PT, DPT, MBA&M (PRESIDENT &CEO)
- **Authorized official phone:** (888) 225-6905

## Contact information

- **Practice address:** 5101C BACKLICK RD, STE 2, ANNANDALE, VA 22003-6061
- **Practice address phone:** (888) 225-6905
- **Practice address fax:** (888) 801-4714
- **Mailing address:** 5101C BACKLICK RD, STE 2, ANNANDALE, VA 22003-6061
- **Mailing address phone:** (888) 225-6905
- **Mailing address fax:** (888) 801-4714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO08450 | VA | Yes |

## Other

- **Enumeration date:** 06/25/2007
- **Last updated:** 12/29/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1659577724 | — | VA |