Revive Behavior Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVIVE BEHAVIOR HEALTH LLC

Practice address

2027 Revere St Ste G
Las Vegas, NV 89106-2327

Phone

(702) 378-8840

NPI assigned

Nov 6, 2018

Organization subpart

No

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

Authorized official

Name

Glories Powell

Title

Owner

Phone

(702) 378-8840

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1609344720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 FINCH RIDGE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890329070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 REVERE ST STE G",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062327",
            "telephone_number": "702-378-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE BEHAVIOR HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "GLORIES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-378-8840"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revenue Care LLC
• Efrain Alejandro Reveron Lopez
• Alessandra Diana Reviglio, DMD
• Arianne Revilla, COTA
• Revitacare Health Centers
• Revive Crisis Clinic LLC
• Revive Injury & Wellness
• Revive Medical Center LLC
• Revive Therapy Health and Wellness Services LLC
• Revived Minds LLC

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.