Organization
REVIVE COMMUNITY HEALTH
Active
Organization
REVIVE COMMUNITY HEALTH
Active
Other names
Revive Community Health LLC, Revive Community Health
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH PHILLIPS (COO)
(602) 717-8599
Entity
Organization
Contact information
Practice address
4700 S MCCLINTOCK DR STE 140, TEMPE, AZ 85282-7375
(480) 851-6309
Mailing address
4700 S MCCLINTOCK DR STE 140, TEMPE, AZ 85282-7375
(480) 851-6309
(573) 240-9791
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/15/2021
Last updated
08/27/2026
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