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Organization
REVITALIZE HEALTHCARE, INC
Active
Organization
REVITALIZE HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY D BABENCO MD (CEO)
(270) 556-1630
Entity
Organization
Contact information
Practice address
657 LONE OAK RD STE 2, PADUCAH, KY 42003-4547
(270) 556-1630
Mailing address
657 LONE OAK RD STE 2, PADUCAH, KY 42003-4547
(270) 556-1630
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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