Provider Demographics
NPI:1013807759
Name:REAVIS
Entity type:Organization
Organization Name:REAVIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:REAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:417-229-7261
Mailing Address - Street 1:5841 SUBURBAN TER
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-6017
Mailing Address - Country:US
Mailing Address - Phone:417-229-7261
Mailing Address - Fax:
Practice Address - Street 1:5841 SUBURBAN TER
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-6017
Practice Address - Country:US
Practice Address - Phone:417-229-7261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health