Revive Premier Recovery Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

REVIVE PREMIER RECOVERY INC.

Practice address

3630 Potosi Ave
Studio City, CA 91604-4059

Phone

(559) 201-3337

NPI assigned

May 16, 2023

Last updated

May 17, 2023By 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

Mr. Kristopher Frontella

Title

Executive Director

Phone

(559) 201-3337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1427749910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 POTOSI AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916044059",
            "telephone_number": "559-201-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 POTOSI AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916044059",
            "telephone_number": "559-201-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PREMIER RECOVERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "FRONTELLA",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "559-201-3337",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Studio City, CA
• Providers in Studio City, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.