Organization
REVIVE HOME HEALTH CARE LLC
Active
Other names
Revive Home Health Care llc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAMONT FLEMON SR. (OWNER)
(314) 825-0997
Entity
Organization
Contact information
Practice address
10174 W FLORISSANT AVE STE 331, SAINT LOUIS, MO 63136-2104
(314) 449-1060
(314) 754-8306
Mailing address
210 N 17TH ST STE 102A, SAINT LOUIS, MO 63103-2518
(314) 449-1060
(314) 669-9921
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487158440
—
MO
Enumeration date
03/22/2018
Last updated
12/17/2025
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