Revive Crisis Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVIVE CRISIS CLINIC LLC

Practice address

2027 Revere St
Las Vegas, NV 89106-2349

Phone

(702) 273-6142

NPI assigned

Nov 11, 2021

Organization subpart

No

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

Authorized official

Name

Stanley Williams

Title

Owner

Phone

(702) 273-6142

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1720744949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 REVERE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 REVERE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062349",
            "telephone_number": "702-273-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CRISIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-273-6142"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Efrain Alejandro Reveron Lopez
• Alessandra Diana Reviglio, DMD
• Arianne Revilla, COTA
• Revitacare Health Centers
• Revive Behavior Health LLC
• Revive Injury & Wellness
• Revive Medical Center LLC
• Revive Therapy Health and Wellness Services LLC
• Revived Minds LLC
• Revivify Wound Care and Soft Tissue Specialist

• Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.