Organization
REVIVE MINISTRIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD JOHNS (CEO)
(859) 354-9841
Entity
Organization
Contact information
Practice address
101 RICHMOND AVE, NICHOLASVILLE, KY 40356-1109
(859) 881-4505
(859) 881-0045
Mailing address
800 S. MAIN STREET, SUITE C, NICHOLASVILLE, KY 40356-1868
(859) 241-5174
(859) 305-6004
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100737830
—
KY
Enumeration date
11/23/2015
Last updated
11/18/2022
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