Revive Athletics, Inc

LBN: Revive Athletics, Inc
Revive Athletics, Inc is an health care organization with primary practice located at 460 Bourne Drive , Smyrna GA 30082. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is the primary health care specialty. Revive Athletics, Inc can be contacted via phone (770) 899-8187, or through Harrell, Matthew via phone (770) 899-8187.

Contact Information

Primary practice address
460 Bourne Drive Smyrna GA 30082
Phone: (770) 899-8187
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Harrell, Matthew
Phone: (770) 899-8187

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X

Profile Details

NPI number 1487964193
LBN Legal business name Revive Athletics, Inc
DBA Doing business as
Authorized official Harrell, Matthew
Entity Organization
Organization subpart 1 No
Enumeration date Oct 15th, 2010
Last updated Oct 15th, 2010 - about 16 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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