REVIVAL MENTAL HEALTH LLC NPI 1922721083

NPI Information

NPI: 1922721083
Provider Name: REVIVAL MENTAL HEALTH LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
9879 HAMILTON AVE
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (949) 606-4681
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REVIVAL MENTAL HEALTH LLC is a community based residential treatment facility mental illness in Fountain Valley, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. REVIVAL MENTAL HEALTH LLC NPI is 1922721083. The provider is registered as an organization entity type.

The provider's business location address is:

9879 HAMILTON AVE
FOUNTAIN VALLEY, CA
ZIP 92708-117
Phone: (949) 606-4681

The provider's authorized official is Tyler Michaelis .
The authorized official title is Managing Member and has the following contact phone number (949) 606-4681.

The enumeration date for this NPI number is 9/23/2022 and was last updated on 1/10/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

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

NPI Synchronization or Removal

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