Revive Integrated Care, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVIVE INTEGRATED CARE, LLC

Practice address

208 Cole Ave
Monroe, LA 71203-3814

Phone

(318) 791-1274

NPI assigned

Jun 3, 2026

Organization subpart

No

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

Authorized official

Name

Lynetta Gipson, RN

Title

Managing Member

Phone

(318) 791-1274

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1629901442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COLE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712033814",
            "telephone_number": "318-612-7836",
            "fax_number": "318-242-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712033814",
            "telephone_number": "318-791-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE INTEGRATED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "GIPSON",
        "authorized_official_first_name": "LYNETTA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-791-1274",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Monroe, LA
• Providers in Monroe, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.