| Organization Name: | REVOLUTIONARY HOME HEALTH INC |
| NPI Number: | 1639566557 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHLEEN EVANINA (ADMINISTRATOR) |
| Mailing Address: | 1619 Main St Olyphant |
| State: | PA US |
| Postal Code: | 184471335 |
| Phone Number: | 5703837502 |
| Fax Number: | 8666007413 |
| NPI Enumeration Date: | 04/17/2015 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 17641601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |