Revita Life
Revita Life is a Dietary Manager in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
Practice location Address checks out
4106 John R Ste 805Detroit, MI 48201
Phone: (313) 745-7454
Fax: (313) 993-8625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dietary Manager (primary) | Taxonomy 132700000X · Licence AN066667 (MI) |
|---|
Record details
| NPI number | 1225139439 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Andre Nunn — President · (313) 745-7454 |
| NPI enumerated | September 26, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 4106 John R, Suite 805, Detroit, MI 48201 |
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