# REVIVE RECOVERY INC.

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

## Provider details

- **NPI number:** 1699293852
- **Authorized official:** JESSICA KEARNS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (603) 882-3616

## Contact information

- **Practice address:** 263 MAIN ST, NASHUA, NH 03060-2936
- **Practice address phone:** (603) 793-2884
- **Mailing address:** 77 NORTHEASTERN BLVD STE C, NASHUA, NH 03062-3128
- **Mailing address phone:** (603) 882-3616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2017
- **Last updated:** 09/07/2017