Organization
REVIVE INTEGRATED CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMALA LASHAWN DANIELS (CEO)
(602) 688-6327
Entity
Organization
Contact information
Practice address
1616 E INDIAN SCHOOL RD STE 400, PHOENIX, AZ 85016-8604
(602) 688-6327
Mailing address
1616 E INDIAN SCHOOL RD STE 400, PHOENIX, AZ 85016-8604
(602) 688-6327
(602) 801-3320
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
07/07/2025
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