Provider Demographics
NPI:1831984368
Name:REVERIE HOME CARE AGENCY, LLC
Entity type:Organization
Organization Name:REVERIE HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MALALAI
Authorized Official - Middle Name:SAIFZADA
Authorized Official - Last Name:SHEKIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-477-2930
Mailing Address - Street 1:12808 QUEENSBURY LN APT E420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3930
Mailing Address - Country:US
Mailing Address - Phone:703-477-2930
Mailing Address - Fax:
Practice Address - Street 1:12808 QUEENSBURY LN APT E420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3930
Practice Address - Country:US
Practice Address - Phone:703-477-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care