| NPI | 1184398331 |
|---|---|
| Doing Business As | REVIVAL RECOVERY CENTER STAFFING |
| Entity Type | Organization |
| Authorized Contact | LISA A PERNA Owner, Authorized Official 248-949-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-09-23 |