Organization
REVIVE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANJA NICOLE MUNDT LPC-S (CEO)
(913) 904-8565
Entity
Organization
Contact information
Practice address
510 S BAY DR, GILBERT, AZ 85233-6539
(913) 904-8565
Mailing address
510 S BAY DR, GILBERT, AZ 85233-6539
(913) 904-8565
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/19/2023
Last updated
07/03/2025
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