| NPI | 1851070882 |
|---|---|
| Doing Business As | REVIVE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER SCHALOW Clinical Director 501-318-3760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |