Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Revitalize Ketamine Clinic LLC

Organization Multi-Specialty Clinic/Center · NPI 1346911195

Revitalize Ketamine Clinic LLC is a Multi-Specialty Clinic/Center in Flagstaff, Arizona. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1800 S Milton Rd Ste 26
Flagstaff, AZ 86001-6340
Phone: (928) 213-6931
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X

Record details

NPI number1346911195
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jill Dubravcic — Owner/Operator · (928) 213-6931
Other names Revketa
NPI enumeratedSeptember 22, 2021
Last updated in NPPESSeptember 22, 2021
Certification dateJuly 13, 2021
Mailing address1800 S Milton Rd Ste 26, Flagstaff, AZ 86001-6340

Other providers in Flagstaff