| Organization Name: | REVIVE HOSPICE CARE, INC. |
| NPI Number: | 1053698134 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEROME DE JESUS (CEO) |
| Mailing Address: | 9229 Utica Ave., Suite 100 Rancho Cucamonga |
| State: | CA US |
| Postal Code: | 917304063 |
| Phone Number: | 8666691686 |
| Fax Number: | 9095328685 |
| NPI Enumeration Date: | 11/03/2011 |
| NPI Last Update Date: | 06/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |