Orange County Revive Services, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ORANGE COUNTY REVIVE SERVICES, INC.

Practice address

24432 Muirlands Blvd Ste 221
Lake Forest, CA 92630-3951

Phone

(949) 510-3358

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Tyler Michaelis

Title

Ceo

Phone

(949) 606-4681

Specialties & licenses 2

Addresses

Other names 1

• OC Revive Doing business as

Tax ID family

Orange County Revive Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Orange County Revive Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Forest, CA
  • NPI 1306543962
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Orange County Revive Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Forest, CA
  • NPI 1306543962
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alejandro Alva, M.D.

  • Psychiatry Physician
  • Costa Mesa, CA
  • NPI 1801816764
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1508333477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD STE 221",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303951",
            "telephone_number": "949-510-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD STE 221",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303951",
            "telephone_number": "949-510-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY REVIVE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "MICHAELIS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-606-4681"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Revive",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OC Revive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suma Oommen, M.D.
• Optimal Function Physical Therapy
• Optimal Health Medical of Orange County
• Orange County Physiotherapy Services, P.C.
• Orange County Revive Services, Inc.
• Alejandro Oropeza
• Ayme Orozco Gonzalez
• Yuliza Ortiz
• Paige Noel Osborne, SLP
• Otoc Occupational Therapy Services Incorporated

• Substance Abuse Rehabilitation Facility in Lake Forest, CA
• Providers in Lake Forest, 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 Sep 30, 2019; 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.