Organization
REVIVE HEALTH CLINICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA F BOCK (MANAGING MEMBER)
(480) 726-2287
Entity
Organization
Contact information
Practice address
1277 E MISSOURI AVE STE 101, PHOENIX, AZ 85014-2916
(602) 296-4106
(602) 296-4146
Mailing address
1839 S ALMA SCHOOL RD STE 354, MESA, AZ 85210-3028
(480) 726-2287
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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