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Organization
REVIVE HOUSING LLC
Active
Organization
REVIVE HOUSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL YOUNG (OWNER)
(281) 217-7857
Entity
Organization
Contact information
Practice address
523 N LONG ST, SALISBURY, NC 28144-4429
(281) 217-7857
Mailing address
323 N MAIN ST, SALISBURY, NC 28144-4301
(281) 217-7857
(704) 519-2708
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
05/26/2020
Last updated
11/30/2023
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