Organization
REVIVE BEHAVIORAL HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LYON LICSW (OWNER)
(308) 850-4330
Entity
Organization
Contact information
Practice address
215 N WHEELER AVE, GRAND ISLAND, NE 68801-5961
(308) 391-2280
(308) 832-4803
Mailing address
215 N WHEELER AVE, GRAND ISLAND, NE 68801-5961
(308) 391-2280
(308) 832-4803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
09/14/2022
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