Revive Integrated Care Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVIVE INTEGRATED CARE SERVICES LLC

Practice address

1616 E Indian School Rd Ste 400
Phoenix, AZ 85016-8604

Phone

(602) 688-6327

NPI assigned

Dec 2, 2022

Organization subpart

No

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

Authorized official

Name

Tamala Lashawn Daniels

Title

Ceo

Phone

(602) 688-6327

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1164132908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E INDIAN SCHOOL RD STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168604",
            "telephone_number": "602-688-6327",
            "fax_number": "602-801-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 E INDIAN SCHOOL RD STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168604",
            "telephone_number": "602-688-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE INTEGRATED CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "TAMALA",
        "authorized_official_middle_name": "LASHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-688-6327"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.