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Organization
REVIVE MENTAL HEALTH NURSING INC
Active
Organization
REVIVE MENTAL HEALTH NURSING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATEVIK GRIGORYAN (PROVIDER)
(818) 217-1212
Entity
Organization
Contact information
Practice address
16933 PARTHENIA ST STE 212, NORTHRIDGE, CA 91343-4574
(818) 217-1212
Mailing address
16933 PARTHENIA ST STE 212, NORTHRIDGE, CA 91343-4574
(818) 217-1212
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
06/19/2026
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