| Revival Therapy Llc | |
|
1163 Water St Ste 5 Indiana PA 15701-1648 | |
| (724) 427-5612 | |
| Not Available |
| Full Name | Revival Therapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1163 Water St Ste 5, Indiana, Pennsylvania |
| Authorized Official Name and Position | Brittany N Hoover (OWNER) |
| Authorized Official Contact | 8142423487 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Therapy Llc 1163 Water St Ste 5 Indiana PA 15701-1648 Ph: (724) 427-5612 | Revival Therapy Llc 1163 Water St Ste 5 Indiana PA 15701-1648 Ph: (724) 427-5612 |
| NPI Number | 1922675446 |
|---|---|
| Provider Enumeration Date | 06/04/2021 |
| Last Update Date | 06/04/2021 |
| Certification Date | 06/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922675446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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