Organization
REVIVE YOURSELF COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAY LINO (LICENSED MENTAL HEALTH THERAPIST)
(941) 565-5184
Entity
Organization
Contact information
Practice address
11757 SHIRBURN CIR, PARRISH, FL 34219-7508
(813) 502-0745
Mailing address
11757 SHIRBURN CIR, PARRISH, FL 34219-7508
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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