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REVITALIZE SUPPORT SERVICES, LLC
NPI 1134081862
Community/Behavioral Health in Baltimore, MD

Active since December 01, 2025
4606 MORAVIA RUN WAY, BALTIMORE, MD 21206(443) 619-1222(443) 619-1222 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revitalize Support Services, Llc NPPES

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

REVITALIZE SUPPORT SERVICES, LLC (NPI 1134081862) is a healthcare organization registered as a community/behavioral health in Baltimore, Maryland and active in the NPI registry since December 2025. The organization lists Irenerenette Ellis, Owner/administrator/president/ceo, as its authorized official.

NPPES Registry Identity

NPI1134081862
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameREVITALIZE SUPPORT SERVICES, LLC
Location Address4606 MORAVIA RUN WAYBaltimore, MD 21206-3582
Mailing Address4606 Moravia Run WayBaltimore, MD 21206-3582 · (443) 619-1222 · Fax (443) 619-1222
Phone(443) 619-1222
Fax(443) 619-1222
Organization SubpartNo
Authorized OfficialIrenerenette EllisOwner/administrator/president/ceo · (443) 619-1222
Enumeration DateDecember 1, 2025
NPPES CertifiedDecember 1, 2025
✔ NPI 1134081862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
4606 MORAVIA RUN WAY, Baltimore, MD 21206
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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 Revitalize Support Services, LLC's NPI number?

The NPI number for Revitalize Support Services, LLC is 1134081862. It was assigned to this organization in the NPPES registry on December 1, 2025.

Where is Revitalize Support Services, LLC located?

Revitalize Support Services, LLC is located at 4606 Moravia Run Way, Baltimore, MD 21206. The listed phone number is (443) 619-1222.

What is Revitalize Support Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Revitalize Support Services, LLC was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.