| Revive Behavioral Health, Llc | |
|
4765 S Lakeshore Dr Tempe AZ 85282-7197 | |
| (480) 418-6386 | |
| Not Available |
| Full Name | Revive Behavioral Health, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4765 S Lakeshore Dr, Tempe, Arizona |
| Authorized Official Name and Position | Tanja Nicole Haaland (CEO) |
| Authorized Official Contact | 9139048565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Behavioral Health, Llc 510 S Bay Dr Gilbert AZ 85233-6539 Ph: (913) 904-8565 | Revive Behavioral Health, Llc 4765 S Lakeshore Dr Tempe AZ 85282-7197 Ph: (480) 418-6386 |
| NPI Number | 1346937588 |
|---|---|
| Provider Enumeration Date | 04/19/2023 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346937588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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