Organization
REVIVE THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERRAH MELTON (CEO)
(480) 243-2718
Entity
Organization
Contact information
Practice address
133 S HALL, MESA, AZ 85204-1325
(480) 243-2718
Mailing address
133 S HALL, MESA, AZ 85204-1325
(480) 243-2718
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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