REVOLUTION HEALTH CENTER NPI 1710473772

NPI Information

NPI: 1710473772
Provider Name: REVOLUTION HEALTH CENTER
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4300 N DECATUR BLVD
LAS VEGAS, NV
ZIP 89130
Phone: (702) 655-2101
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REVOLUTION HEALTH CENTER is a mental health counselor in Las Vegas, NV. REVOLUTION HEALTH CENTER NPI is 1710473772. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4300 N DECATUR BLVD
LAS VEGAS, NV
ZIP 89130
Phone: (702) 655-2101

The provider's authorized official is David Grillo .
The authorized official title is Managing Member and has the following contact phone number (310) 994-6411.

The enumeration date for this NPI number is 7/2/2018 and was last updated on 7/5/2018.

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	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	103TC1900X	Psychologist	Counseling	No
3	261QM0850X	Clinic/Center	Adult Mental Health	No
4	101YM0800X	Counselor	Mental Health	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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