Organization
REVIDA RECOVERY CENTERS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW THOMAS DO (CEO)
(423) 631-0432
Entity
Organization
Contact information
Practice address
300 VALLEY ST NE, ABINGDON, VA 24210-2912
(276) 206-8197
Mailing address
3322 W END AVE STE 350, NASHVILLE, TN 37203-6911
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013483486
—
VA
05
—
Q045064
—
TN
Enumeration date
10/23/2018
Last updated
09/08/2025
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