| Revival Collaborative Llc | |
|
3700 Medical Center Pkwy Bentonville AR 72712-3222 | |
| (479) 721-2110 | |
| Not Available |
| Full Name | Revival Collaborative Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3700 Medical Center Pkwy, Bentonville, Arkansas |
| Authorized Official Name and Position | Zach S Hedges (OWNER) |
| Authorized Official Contact | 4797212110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Collaborative Llc 3202 Sw Hazelnut Ave Bentonville AR 72713-3195 Ph: (479) 721-2110 | Revival Collaborative Llc 3700 Medical Center Pkwy Bentonville AR 72712-3222 Ph: (479) 721-2110 |
| NPI Number | 1407515620 |
|---|---|
| Provider Enumeration Date | 12/15/2021 |
| Last Update Date | 12/15/2021 |
| Certification Date | 12/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407515620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Katherine C Shook, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 307 Sw 18th St Ste 3, Bentonville, AR 72712 Phone: 479-721-1788 | |
Fleuri, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Se Otis Corley Dr Ste 14, Bentonville, AR 72712 Phone: 318-245-3437 | |
Emerge Therapy Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2713 Se I St Ste 5, Bentonville, AR 72712 Phone: 479-250-4355 Fax: 479-553-7954 | |
Jennifer Burleson Lcsw, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1116 S Walton Blvd Ste 114, Bentonville, AR 72712 Phone: 917-405-5514 | |
Wh Nj Medical Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 702 Sw 8th St # Ms 0215, Bentonville, AR 72716 Phone: 479-258-2080 | |
Wh Ks Medical Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 702 Sw 8th Street, Mail Stop 0445, Bentonville, AR 72716 Phone: 479-360-0304 | |
Tciy Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Se 28th St Ste 3, Bentonville, AR 72712 Phone: 479-295-3325 Fax: 888-630-4808 |