| Organization Name: | REVELATION HOSPICE AND PALLIATIVE CARE, LLC |
| NPI Number: | 1558695072 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDRE' KIRKLAND (CEO) |
| Mailing Address: | 89 Delta Ave Suite 104 Clarksdale |
| State: | MS US |
| Postal Code: | 386142749 |
| Phone Number: | 6627199209 |
| Fax Number: | |
| NPI Enumeration Date: | 09/30/2009 |
| NPI Last Update Date: | 09/30/2009 |
| 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: | |