Organization
REVIVE INTEGRATED CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTA GIPSON RN (MANAGING MEMBER)
(318) 791-1274
Entity
Organization
Contact information
Practice address
208 COLE AVE, MONROE, LA 71203-3814
(318) 791-1274
Mailing address
208 COLE AVE, MONROE, LA 71203-3814
(318) 791-1274
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/03/2026
Last updated
06/03/2026
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