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1407515620
REVIVAL COLLABORATIVE LLC
BENTONVILLE, AR
NPI
1407515620
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Entity Type
Organization
Authorized Contact
ZACH S HEDGES
Owner
479-721-2110
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2021-12-15
Last Update Date
2021-12-15
Business Address
REVIVAL COLLABORATIVE LLC
3700 MEDICAL CENTER PKWY
BENTONVILLE, AR 72712-3222
Phone number: 479-721-2110
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Mailing Address
REVIVAL COLLABORATIVE LLC
3202 SW HAZELNUT AVE
BENTONVILLE, AR 72713-3195
Phone number: 479-721-2110
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