# REVIVE PSYCHIATRIC SERVICES, LLC

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

## Provider details

- **NPI number:** 1225504962
- **Authorized official:** SETH JORDAN BOWERS PMHNP-BC (OWNER/PROVIDER)
- **Authorized official phone:** (337) 247-2533

## Contact information

- **Practice address:** 221 RUE DE JEAN STE 210, LAFAYETTE, LA 70508-3283
- **Practice address phone:** (337) 450-9452
- **Practice address fax:** (337) 222-3934
- **Mailing address:** PO BOX 530, YOUNGSVILLE, LA 70592-0530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/21/2018
- **Last updated:** 10/31/2024