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REVITA LIFE
NPI 1225139439
Dietary Manager in Detroit, MI

Active since September 26, 2006
4106 JOHN R, SUITE 805, DETROIT, MI 48201(313) 745-7454(313) 993-8625 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Revita Life NPPES

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

REVITA LIFE (NPI 1225139439) is a healthcare organization registered as a dietary manager in Detroit, Michigan and active in the NPI registry since September 2006. The organization lists Andre R Nunn, President, as its authorized official.

NPPES Registry Identity

NPI1225139439
Entity TypeOrganization
Primary Taxonomy132700000X
Legal Business NameREVITA LIFE
Location Address4106 JOHN R, SUITE 805Detroit, MI 48201
Mailing Address4106 John R, Suite 805Detroit, MI 48201 · (313) 745-7454 · Fax (313) 993-8625
Phone(313) 745-7454
Fax(313) 993-8625
Organization SubpartNo
Authorized OfficialAndre R NunnPresident · (313) 745-7454
Enumeration DateSeptember 26, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1225139439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietary ManagerDietary & Nutritional Service Providers
Taxonomy Code132700000X
License✔ Licensed in MI · AN066667
Definition
A dietary manager is a trained food services professional who is charged with maintaining cost/profit objectives, purchasing foods and services for the department and supervising staff.. Dietary managers are trained to understand the basic nutritional needs of clients and work in partnership with dietitians, who offer specialized nutritional expertise. The CDM certified dietary manager designation is an advanced professional credential awarded to dietary managers who have completed specific course work, have passed the national credentialing exams (including a sanitation and safety exam) and have applied for certification.
4106 JOHN R, Detroit, MI 48201
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Revita Life's NPI number?

The NPI number for Revita Life is 1225139439. It was assigned to this organization in the NPPES registry on September 26, 2006.

Where is Revita Life located?

Revita Life is located at 4106 John R Suite 805, Detroit, MI 48201. The listed phone number is (313) 745-7454.

What is Revita Life's specialty?

The primary specialty registered for this NPI is Dietary Manager with taxonomy code 132700000X.

When was this NPI record last updated?

The NPPES record for Revita Life was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.