NPI Index

LIFE REVIVAL LLC

Community/Behavioral Health

Active Organization
NPI: 1023701067

Practice Address

6404 ROOSEVELT BLVD
Philadelphia, PA 19149

Phone: (267) 577-7747

Specialties

Specialty Code Primary License
Counselor - Mental Health 101YM0800X No -
Psychologist - Counseling 103TC1900X No -
Psychologist - Family 103TF0000X No -
Psychologist - Psychoanalysis 103TP0814X No -
Psychologist - Group Psychotherapy 103TP2701X No -
Social Worker - Clinical 1041C0700X No -
Psychiatry & Neurology - Psychiatry 2084P0800X No -
Psychiatry & Neurology - Child & Adolescent Psychiatry 2084P0804X No -
Psychiatry & Neurology - Geriatric Psychiatry 2084P0805X No -
Case Management 251B00000X No -
Clinic/Center - Mental Health (Including Community Mental Health Center) 261QM0801X No -
Clinic/Center - Adult Mental Health 261QM0850X No -
Clinic/Center - Adolescent and Children Mental Health 261QM0855X No -
Nurse Practitioner - Psychiatric/Mental Health 363LP0808X No -
Community/Behavioral Health 251S00000X Yes -

Frequently Asked Questions

NPI 1023701067 is the National Provider Identifier for LIFE REVIVAL LLC, a Community/Behavioral Health provider located in Philadelphia, PA. This NPI was enumerated on May 26, 2023.

Quick Facts

NPI
1023701067
Type
Organization
Enumerated
May 26, 2023
Last Updated
Feb 11, 2025

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