A Life Revival Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

A LIFE REVIVAL COMMUNITY SERVICES

Practice address

234 Goldenstar LN
Portsmouth, VA 23701-4324

Phone

(757) 376-2620

NPI assigned

Aug 27, 2025

Last updated

Aug 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Powell II

Title

Executive Director

Phone

(757) 376-2620

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1205715034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 GOLDENSTAR LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237014324",
            "telephone_number": "757-376-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOLDENSTAR LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237014324",
            "telephone_number": "757-376-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A LIFE REVIVAL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-376-2620",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.