Organization
REVIVE RECOVERY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA DEPUGH CNP (OWNER)
(740) 708-5019
Entity
Organization
Contact information
Practice address
1886 BLAIN HWY, WAVERLY, OH 45690-9070
(740) 708-5019
Mailing address
1886 BLAIN HWY, WAVERLY, OH 45690-9070
(740) 708-5019
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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