NPIMap

Organization Active NPI

Revive Therapies LLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1669125571
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
REVIVE THERAPIES LLC
Practice address
133 S Hall
Mesa, AZ 85204-1325
Phone
(480) 243-2718
NPI assigned
Jan 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Ferrah MeltonNPI 1144932625
Title
Ceo
Phone
(480) 243-2718

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

133 S Hall
Mesa, AZ 85204-1325

Mailing address

133 S Hall
Mesa, AZ 85204-1325
Phone (480) 243-2718

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1669125571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 S HALL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041325",
            "telephone_number": "480-243-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 S HALL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041325",
            "telephone_number": "480-243-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "FERRAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-243-2718"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.