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

Revival IV and Wellness Clinic LLC

Organization Clinic/Center · NPI 1033974878

Revival IV and Wellness Clinic LLC is a Clinic/Center in Shelton, Connecticut. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12 Progress Dr Ste 1D
Shelton, CT 06484-6290
Phone: (475) 314-3011
Fax: (475) 314-3011
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1033974878
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keisha Asante — Fnp · (475) 314-3011
NPI enumeratedFebruary 20, 2024
Last updated in NPPESFebruary 20, 2024
Certification dateFebruary 20, 2024
Mailing address120 Longview Dr, Stratford, CT 06614-1398

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