Revive Health LLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

Legal business name

REVIVE HEALTH LLC

Practice address

13715 Oaklands Manor Dr
Laurel, MD 20708-1430

Phone

(443) 945-8482

NPI assigned

Sep 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Tancho, CRNP

Title

Ceo

Phone

(443) 945-8482

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1003530502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13715 OAKLANDS MANOR DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081430",
            "telephone_number": "443-945-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13715 OAKLANDS MANOR DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081430",
            "telephone_number": "443-945-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "TANCHO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-945-8482",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in Laurel, MD
• Providers in Laurel, MD by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.