# REVIVE 3.23, LLC

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

## Provider details

- **NPI number:** 1821778788
- **Authorized official:** MRS. JOI IMAN GRESHAM MSW, LICSW (OWNER)
- **Authorized official phone:** (205) 215-4211

## Contact information

- **Practice address:** 200 BEACON PKWY W STE 101, BIRMINGHAM, AL 35209-3102
- **Practice address phone:** (205) 215-4211
- **Mailing address:** 301 8TH PL, PLEASANT GROVE, AL 35127-1829
- **Mailing address phone:** (205) 215-4211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2023
- **Last updated:** 07/24/2023