| 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 |