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REVIVAL COUNSELING CENTER NPI 1326713215


NPI Information

NPI: 1326713215
Provider Name: REVIVAL COUNSELING CENTER
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 04D2233754

Address:
1632 STRAWFLOOR DRIVE
JONESBORO, AR
ZIP 72401
Phone: (870) 243-8650
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REVIVAL COUNSELING CENTER is a substance abuse rehabilitation facility in Jonesboro, AR. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. REVIVAL COUNSELING CENTER NPI is 1326713215. The provider is registered as an organization entity type.

The provider's business location address is:

1632 STRAWFLOOR DRIVE
JONESBORO, AR
ZIP 72401-546
Phone: (870) 243-8650

The provider's authorized official is Sarah Rackley .
The authorized official title is Office Manager and has the following contact phone number (870) 243-8650.

The CLIA number assigned to this NPI record is 04D2233754 - other - mental health faclity with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2021 and was last updated on 6/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.