Organization
REVITALIZE BEHAVIORAL SERVICES, LLC
Active
Organization
REVITALIZE BEHAVIORAL SERVICES, LLC
Active
Other names
Revitalize Behavioral Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA VALDIVIA QMHP-C/A (OWNER)
(757) 553-8416
Entity
Organization
Contact information
Practice address
5215 COLLEY AVE, NORFOLK, VA 23508-2166
(757) 553-8416
Mailing address
4608 MAYFLOWER RD, NORFOLK, VA 23508-2740
(757) 553-8416
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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