Organization
REVIVAL HOME SUPPORT L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA VERCILISE LAMOTHE (MANAGER)
(407) 360-7309
Entity
Organization
Contact information
Practice address
8725 WELLESLEY LAKE DR APT 203, ORLANDO, FL 32818-6303
(407) 360-7309
Mailing address
8725 WELLESLEY LAKE DR APT 203, ORLANDO, FL 32818-6303
(407) 360-7309
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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