Revive Recovery Center Llc

LBN: Revive Recovery Center Llc
Revive Recovery Center Llc is an health care organization with primary practice located at 127 W Juanita Ave Ste 110 , Mesa AZ 85210-6114. The organization recently has 4 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty. Revive Recovery Center Llc can be contacted via phone (424) 212-9052, or through Younghusband, Brayden via phone (000) 000-0000.

Contact Information

Primary practice address
127 W Juanita Ave Ste 110 Mesa AZ 85210-6114
Phone: (424) 212-9052
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Younghusband, Brayden
Phone: (000) 000-0000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1851007272
LBN Legal business name Revive Recovery Center Llc
DBA Doing business as
Authorized official Younghusband, Brayden
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2023
Last updated Apr 23rd, 2023 - about 3 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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