Organization
A LIFE REVIVAL COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC POWELL II (EXECUTIVE DIRECTOR)
(757) 376-2620
Entity
Organization
Contact information
Practice address
234 GOLDENSTAR LN, PORTSMOUTH, VA 23701-4324
(757) 376-2620
Mailing address
234 GOLDENSTAR LN, PORTSMOUTH, VA 23701-4324
(757) 376-2620
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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