Organization
DQ REVITALIZATION LLC
Active
Other names
no other name
Organization subpart
No
Provider details
NPI number
Authorized official
LATANYA MARIE FOUNTAIN LPN (OWNER)
(504) 270-8024
Entity
Organization
Contact information
Practice address
15255 FM 529 RD APT 6201, HOUSTON, TX 77095-5645
(504) 270-8024
Mailing address
15255 FM 529 RD APT 6201, HOUSTON, TX 77095-5645
(504) 270-8024
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
09/16/2025
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