# REVIVE THERAPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Temenos Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457822462
- **Authorized official:** SALLY VON ERFFA LMFT (MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (505) 252-6797

## Contact information

- **Practice address:** 7013 4TH ST NW STE C, LOS RANCHOS, NM 87107-6639
- **Practice address phone:** (505) 356-2200
- **Practice address fax:** (844) 272-7030
- **Mailing address:** 376 LOS RANCHOS RD NW, LOS RANCHOS, NM 87107-6532
- **Mailing address phone:** (505) 252-6797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2018
- **Last updated:** 12/05/2024