Organization
REVIVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA TANCHO CRNP (CEO)
(443) 945-8482
Entity
Organization
Contact information
Practice address
13715 OAKLANDS MANOR DR, LAUREL, MD 20708-1430
(443) 945-8482
Mailing address
13715 OAKLANDS MANOR DR, LAUREL, MD 20708-1430
(443) 945-8482
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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