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Organization
REVIVED MIND COUNSELING SERVICES
Active
Organization
REVIVED MIND COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY GALLEGOS (CREDENTIALING MANAGER)
(517) 483-2461
Entity
Organization
Contact information
Practice address
2705 TAPESTRY DR, OKEMOS, MI 48864-4611
(517) 930-9950
(517) 323-9531
Mailing address
2705 TAPESTRY DR, OKEMOS, MI 48864-4611
(517) 930-9950
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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