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

Revival Reentry

Organization Meals Provider · NPI 1477340735

Revival Reentry is a Meals Provider in Ukiah, California. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
7

Practice location Address checks out

521 Capps Ln
Ukiah, CA 95482-7227
Phone: (707) 376-5086
Show map & directions

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

Specialties & licences

Voluntary or Charitable Agency (primary) Taxonomy 251V00000X
Meals Provider Taxonomy 174200000X
Lodging Provider Taxonomy 177F00000X
Local Education Agency (LEA) Taxonomy 251300000X
Case Management Agency Taxonomy 251B00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
In Home Supportive Care Agency Taxonomy 253Z00000X

Record details

NPI number1477340735
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Elliott — President/Ceo · (707) 376-5086
NPI enumeratedApril 21, 2025
Last updated in NPPESApril 21, 2025
Certification dateApril 21, 2025
Mailing address521 Capps Ln, Ukiah, CA 95482-7227