Organization
REVIVE COUNSELING AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL ROWE LCSW (OWNER)
(219) 379-4362
Entity
Organization
Contact information
Practice address
317 S EDDY ST, SOUTH BEND, IN 46617-3201
(219) 379-4362
Mailing address
317 S EDDY ST, SOUTH BEND, IN 46617-3201
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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