Revive Recovery

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVIVE RECOVERY

Practice address

18990 Westbay LN
Waterville, MN 56096-4138

Phone

(507) 456-1633

NPI assigned

Apr 11, 2026

Last updated

Apr 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen Kay Theissen

Title

Board of Dir - Secretary/Treasurer

Phone

(507) 456-1633

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1775865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775865600000",
    "number": "1982547295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18990 WESTBAY LN",
            "city": "WATERVILLE",
            "state": "MN",
            "postal_code": "560964138",
            "telephone_number": "507-456-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 WESTBAY LN",
            "city": "WATERVILLE",
            "state": "MN",
            "postal_code": "560964138",
            "telephone_number": "507-456-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-11",
        "last_updated": "2026-04-11",
        "certification_date": "2026-04-11",
        "status": "A",
        "authorized_official_last_name": "THEISSEN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "BOARD OF DIR - SECRETARY/TREASURER",
        "authorized_official_telephone_number": "507-456-1633"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Kay Cook, RPH
• Angela Ann Dahlberg
• Kathryn Johnson, RD, LD
• Le Sueur Residence Inc
• Kristin Mertins, RN, BSN
• William Allen Struve, DDS
• Sunrise Products of Waterville Minnesota Inc (Sunrise Products)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Waterville)
• Unique Abilities, LLC
• Marilyn K. Waldschmidt, M.D.

• Community/Behavioral Health Agency in Waterville, MN
• Providers in Waterville, MN by specialty
• Community/Behavioral Health Agency in Minnesota

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