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Organization
REVIVE 3.23, LLC
Active
Organization
REVIVE 3.23, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOI IMAN GRESHAM MSW, LICSW (OWNER)
(205) 215-4211
Entity
Organization
Contact information
Practice address
200 BEACON PKWY W STE 101, BIRMINGHAM, AL 35209-3102
(205) 215-4211
Mailing address
301 8TH PL, PLEASANT GROVE, AL 35127-1829
(205) 215-4211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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