Revival Therapy Inc

LBN: Revival Therapy Inc
Revival Therapy Inc is an health care organization with primary practice located at 330 W Terra Cotta Ave Ste 4 , Crystal Lake IL 60014-3552. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is the primary health care specialty. Revival Therapy Inc can be contacted via phone (815) 382-9691, or through Lemke, Sara via phone (815) 451-6585.

Contact Information

Primary practice address
330 W Terra Cotta Ave Ste 4 Crystal Lake IL 60014-3552
Phone: (815) 382-9691
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lemke, Sara LCPC, CADC
Phone: (815) 451-6585

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1376150896
LBN Legal business name Revival Therapy Inc
DBA Doing business as
Authorized official Lemke, Sara LCPC, CADC
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2020
Last updated Feb 2nd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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