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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