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
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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