REVIVE RECOVERY CENTER LLC NPI 1902771777

NPI Information

  • NPI: 1902771777
  • Provider Name: REVIVE RECOVERY CENTER LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Address: 2654 S VINCENT
    MESA, AZ
    ZIP 85209
  • Phone: (480) 470-6042

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NPI Details

REVIVE RECOVERY CENTER LLC is a substance abuse rehabilitation facility in Mesa, AZ. 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. REVIVE RECOVERY CENTER LLC NPI is 1902771777. The provider is registered as an organization entity type.

The provider's business location address is:

2654 S VINCENT
MESA, AZ
ZIP 85209-486
Phone: (480) 470-6042

The provider's authorized official is Brayden Younghusband .
The authorized official title is Ceo and has the following contact phone number (480) 470-6042.

The enumeration date for this NPI number is 10/9/2025 and was last updated on 10/9/2025.

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
1324500000XSubstance 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: 3/30/2025

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