LIFE REVIVAL LLC
Organization (NPI-2)
Active
Community/Behavioral Health
Provider Information
- NPI Number
1023701067- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 6404 ROOSEVELT BLVD, PHILADELPHIA, PA, 191492943
- Phone
- (267) 577-7747
Specialties & Taxonomies
Counselor, Mental Health
Psychologist, Counseling
Psychologist, Family
Psychologist, Psychoanalysis
Psychologist, Group Psychotherapy
Social Worker, Clinical
Psychiatry & Neurology, Psychiatry
Psychiatry & Neurology, Child & Adolescent Psychiatry
Unknown
Case Management
Community/Behavioral Health
Primary
Clinic/Center, Mental Health (Including Community Mental Health Center)
Clinic/Center, Adult Mental Health
Clinic/Center, Adolescent and Children Mental Health
Nurse Practitioner, Psych/Mental Health
All Addresses
MAILING
6404 ROOSEVELT BLVD
PHILADELPHIA, PA, 191492943