RESEREVELATIONS LLC NPI 1083326706

NPI Information

NPI: 1083326706
Provider Name: RESEREVELATIONS, LLC
Classification: Voluntary or Charitable - 251V00000X
Entity Type: Organization
Other Name: MKC REALITY, INC
Address: 31 S MAIN ST
DAYTON, OH
ZIP 45402
Phone: (937) 860-1038

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NPI Details

RESEREVELATIONS, LLC is a voluntary or charitable in Dayton, OH. RESEREVELATIONS, LLC NPI is 1083326706. The provider is registered as an organization entity type.
The provider Other Name Is Mkc Reality, Inc.

The provider's business location address is:

31 S MAIN ST
DAYTON, OH
ZIP 45402-070
Phone: (937) 860-1038
Fax: (270) 203-0587

The provider's authorized official is De'rese Zyire Gooden .
The authorized official title is Ceo, Owner & Director and has the following contact phone number (937) 860-1038.

The enumeration date for this NPI number is 12/14/2022 and was last updated on 1/5/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	251B00000X	Case Management	No
2	251C00000X	Day Training, Developmentally Disabled Services	No
3	251K00000X	Public Health or Welfare	No
4	251S00000X	Community/Behavioral Health	No
5	251V00000X	Voluntary or Charitable	Yes
6	253Z00000X	In Home Supportive Care	No
7	347C00000X	Private Vehicle	No
8	372500000X	Chore Provider	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0307155	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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