REVIVAL HOME CARE
NPI 1336498906
Assisted Living Facility - Assisted Living, Behavioral Disturbances in Glendale, AZ

NPI Status: Active since August 29, 2012

Contact Information

8269 W STATE AVE
GLENDALE, AZ
ZIP 85303
Phone: (602) 334-4187
Fax: (602) 334-4187

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  • Organization
  • Assisted Living Facility
  • Assisted Living, Behavioral Disturbances

About REVIVAL HOME CARE

This page provides the complete NPI Profile along with additional information for Revival Home Care, a provider established in Glendale, Arizona operating as a Assisted Living Facility, focusing in assisted living, behavioral disturbances . The healthcare provider is registered in the NPI registry with number 1336498906 assigned on August 2012. The practitioner's primary taxonomy code is 3104A0630X with license number AL8758H (AZ). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mrs. Fidelite Kankindi Mbr (Caregiver)

NPI
1336498906
Provider Name
REVIVAL HOME CARE
Entity Type
Organization
Location Address
8269 W STATE AVE GLENDALE, AZ 85303
Location Phone
(602) 334-4187
Location Fax
(602) 334-4187
Mailing Address
8269 W STATE AVE GLENDALE, AZ 85303
Mailing Phone
(602) 334-4187
Mailing Fax
(602) 334-4187
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-29-2012
Last Update Date
08-29-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility Assisted Living, Behavioral Disturbances

Taxonomy Code
3104A0630X
Type
Nursing & Custodial Care Facilities
License No.
AL8758H
License State
AZ
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. FIDELITE KANKINDI MBR

Authorized Official Title
CAREGIVER
Authorized Official Phone
(623) 297-1305

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1336498906
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2366891690
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 8 + 9 + 1 + 6 + 9 + 0 + 24 = 74
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 74 = 66

The NPI number 1336498906 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336498906, enumerated in the NPI registry as an "organization" on August 29, 2012

The provider is located at 8269 W State Ave Glendale, Az 85303 and the phone number is (602) 334-4187

This medical organization specializes in Assisted Living Facility with taxonomy code 3104A0630X with a focus in Assisted Living, Behavioral Disturbances

This NPI record was last updated on August 29, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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