Organization
REVIVAL BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LEE RIVET PMHNP-BC, MSN, APRN (OWNER)
(603) 716-5178
Entity
Organization
Contact information
Practice address
235 AFRICA RD, ALTON, NH 03809-5105
(603) 716-5178
Mailing address
PO BOX 552, ALTON, NH 03809-0552
(603) 716-5178
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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