| Orange County Revive Services, Inc. | |
|
23726 Birtcher Dr Lake Forest CA 92630-1771 | |
| (949) 606-4681 | |
| Not Available |
| Full Name | Orange County Revive Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 23726 Birtcher Dr, Lake Forest, California |
| Authorized Official Name and Position | Tyler Michaelis (CEO) |
| Authorized Official Contact | 9496064681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Revive Services, Inc. 23726 Birtcher Dr Lake Forest CA 92630-1771 Ph: () - | Orange County Revive Services, Inc. 23726 Birtcher Dr Lake Forest CA 92630-1771 Ph: (949) 606-4681 |
| NPI Number | 1306543962 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306543962 | NPI | - | NPPES |
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