1. Home
  2. Directory
  3. Connecticut
  4. Shelton
  5. Clinic Center
  6. NPI Profile

REVIVAL IV AND WELLNESS CLINIC LLC
NPI 1033974878
Clinic/Center in Shelton, CT

Active since February 20, 2024
12 PROGRESS DR STE 1D, SHELTON, CT 06484(475) 314-3011(475) 314-3011 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revival Iv And Wellness Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVAL IV AND WELLNESS CLINIC LLC (NPI 1033974878) is a healthcare organization registered as a clinic/center in Shelton, Connecticut and active in the NPI registry since February 2024. The organization lists Keisha Asante, Fnp, as its authorized official.

NPPES Registry Identity

NPI1033974878
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameREVIVAL IV AND WELLNESS CLINIC LLC
Location Address12 PROGRESS DR STE 1DShelton, CT 06484-6290
Mailing Address120 Longview DrStratford, CT 06614-1398
Phone(475) 314-3011
Fax(475) 314-3011
Organization SubpartNo
Authorized OfficialKeisha AsanteFnp · (475) 314-3011
Enumeration DateFebruary 20, 2024
NPPES CertifiedFebruary 20, 2024
✔ NPI 1033974878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
12 PROGRESS DR STE 1D, Shelton, CT 06484
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KEISHA ASANTE
Nurse Practitioner (Family)
12 PROGRESS DR STE 1D
SHELTON, CT 06484
Naugatuck Valley Planning Region (475) 314-3011

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revival IV And Wellness Clinic LLC's NPI number?

The NPI number for Revival IV And Wellness Clinic LLC is 1033974878. It was assigned to this organization in the NPPES registry on February 20, 2024.

Where is Revival IV And Wellness Clinic LLC located?

Revival IV And Wellness Clinic LLC is located at 12 Progress Dr Ste 1D, Shelton, CT 06484. The listed phone number is (475) 314-3011.

What is Revival IV And Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Revival IV And Wellness Clinic LLC was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.