OrganizationRevive Health Center Of Utah LlcLicensed Practical NurseNursing Service ProvidersPractice Address3080 N Fairfield Rd, Suite 1, Layton, UT 84041-8694(801) 820-6585PECOS EnrollmentBased on the most recent information from CMS, provider Revive Health Center Of Utah Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:46 AM.Profile DetailsProvider ID1184042236Provider TypeOrganizationFull NameRevive Health Center Of Utah LlcSubpartNoEnumeration Date4/4/2014Last Updated4/4/2014Contact InformationPractice LocationPractice Address3080 N Fairfield Rd, Suite 1, Layton, UT 84041-8694Phone(801) 820-6585FaxUnlisted FaxMailing LocationMailing Address3080 N Fairfield Rd, Suite 1, Layton, UT 84041-8694Phone(801) 820-6585FaxUnlisted FaxAuthorized OfficialNameTippetts, Jacob (Administrator)Phone(801) 820-6585Provider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense1851542872Utah