NPI | 1093361032 |
---|---|
Doing Business As | REVIVAL THERAPY |
Entity Type | Organization |
Authorized Contact | DANNY ALDIS Therapy Supervisor 702-401-1345 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2019-08-15 |
Last Update Date | 2022-02-03 |