Organization
NEW REVIVE HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUAMART LEWIS (PROGRAM ADMINISTRATOR)
(623) 680-6797
Entity
Organization
Contact information
Practice address
44263 W. MCCLELLAND DRIVE, MARICOPA, AZ 85138
(623) 264-5400
(623) 264-5700
Mailing address
44263 W. MCCLELLAND DRIVE, MARICOPA, AZ 85138
(623) 264-5400
(623) 264-5700
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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