Revive Housing LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVIVE HOUSING LLC

Practice address

523 N Long St
Salisbury, NC 28144-4429

Phone

(281) 217-7857

NPI assigned

May 26, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Young

Title

Owner

Phone

(281) 217-7857

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1083237986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N MAIN ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281444301",
            "telephone_number": "281-217-7857",
            "fax_number": "704-519-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N LONG ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281444429",
            "telephone_number": "281-217-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HOUSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-11-30",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-217-7857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "address_1": "523 N Long St",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281444429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert William Reindollar, MD
• Stephanie Ann Rendon
• Leslie Sierra Renten, M.D.
• Hernane C Restar
• Alexandra Reustle, PSY.D.
• Revive Therapeutic Services
• Shomara Reyes
• Yeimi Lizbeth Reyna Romero
• Brooke Reynolds
• Jesse Reynolds, PT

• Community/Behavioral Health Agency in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.