Revival Housing LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVIVAL HOUSING LLC

Practice address

140 Belvidere St W
West St Paul, MN 55118-5717

Phone

(952) 239-6790

NPI assigned

Feb 24, 2026

Organization subpart

No

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

Authorized official

Name

Lawrence Tan

Title

Cfo

Phone

(651) 338-8512

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1841144912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 DALY ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023550",
            "telephone_number": "952-239-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BELVIDERE ST W",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551185717",
            "telephone_number": "952-239-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL HOUSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-338-8512"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in West St Paul, MN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.