Organization
REVIVE PREMIER TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRISTOPHER FRONTELLA (EXECUTIVE DIRECTOR)
(559) 201-3337
Entity
Organization
Contact information
Practice address
13111 VENTURA BLVD, STUDIO CITY, CA 91604-2218
(559) 201-3337
Mailing address
13111 VENTURA BLVD, STUDIO CITY, CA 91604-2218
(559) 201-3337
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
07/11/2022
Update your record
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