# REVIVAL BEHAVIORAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093511891
- **Authorized official:** JESSICA LEE RIVET PMHNP-BC, MSN, APRN (OWNER)
- **Authorized official phone:** (603) 716-5178

## Contact information

- **Practice address:** 235 AFRICA RD, ALTON, NH 03809-5105
- **Practice address phone:** (603) 716-5178
- **Mailing address:** PO BOX 552, ALTON, NH 03809-0552
- **Mailing address phone:** (603) 716-5178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2025
- **Last updated:** 02/21/2025