| Revel Human Services Llc | |
|
1608 E Chelsea Dr San Tan Valley AZ 85140-5666 | |
| (480) 465-7265 | |
| Not Available |
| Full Name | Revel Human Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1608 E Chelsea Dr, San Tan Valley, Arizona |
| Authorized Official Name and Position | Deana Perry (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4804657265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revel Human Services Llc 1608 E Chelsea Dr San Tan Valley AZ 85140-5666 Ph: (480) 465-7265 | Revel Human Services Llc 1608 E Chelsea Dr San Tan Valley AZ 85140-5666 Ph: (480) 465-7265 |
| NPI Number | 1154978799 |
|---|---|
| Provider Enumeration Date | 08/19/2019 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Medicare PECOS PAC ID | 0941635932 |
|---|---|
| Medicare Enrollment ID | O20200122000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154978799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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