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Organization
REVIVAL THERAPY SERVICES LLC
Active
Organization
REVIVAL THERAPY SERVICES LLC
Active
Parent organization
REVIVAL THERAPY SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
REVIVAL THERAPY SERVICES LLC
Authorized official
SACHA LACASSE (DIRECTOR)
(720) 441-4622
Entity
Organization
Contact information
Practice address
1133 N PENNSYLVANIA ST, DENVER, CO 80203-2502
(303) 551-0117
(303) 551-0117
Mailing address
1133 N PENNSYLVANIA ST, DENVER, CO 80203-2502
(303) 551-0117
(303) 551-0117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/08/2022
Last updated
10/25/2024
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