Organization
REVIVE HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE HERRERA (PRACTICE MANAGER)
(520) 483-1698
Entity
Organization
Contact information
Practice address
1550 E FLORENCE BLVD STE 104, CASA GRANDE, AZ 85122-4788
(520) 483-6386
Mailing address
1550 E FLORENCE BLVD STE 104, CASA GRANDE, AZ 85122-4788
(520) 635-5318
(833) 983-2946
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/25/2025
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