REVIVE HOUSING LLC


Address: 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147
Phone: 2812177857

REVIVE HOUSING LLC (NPI# 1083237986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083237986
Entity Type Organization
Organization Name REVIVE HOUSING LLC
Practice Address 210 Sunset Dr Apt 615
Salisbury
NC 28147-7147
Practice Telephone 2812177857
Mailing Telephone 2182177857
Enumeration Date 2020-05-26
Last Update Date 2020-05-28
Authorized Official Name MR. DANIEL YOUNG (OWNER)
Authorized Official Telephone 2812177857
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Office Location

Street Address 210 SUNSET DR APT 615
City SALISBURY
State NC
Zip Code 28147-7147

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1689054777 Travis Howell Occupational Therapist 548 White Oak Drive, Apt 310, Salisbury, NC 28147 2015-06-03
1790115384 Urgent Cares of America North Carolina Inc Non-Pharmacy Dispensing Site 1361 Klumac Road, Salisbury, NC 28147 2013-11-18
1336499409 Ashley Elizabeth Jones Speech-Language Pathologist 701julian Road, Salisbury, NC 28147 2012-09-14
1730489360 Shepherd's Home Care Home Health 1953 W Jake Alexander Blvd, 2, Salisbury, NC 28147 2010-10-29
1346369006 Denise Murphy Occupational Therapist 548 White Oaks Dr, Salisbury, NC 28147 2007-03-27
1205992203 Robert N Whitaker Jr Md Pa Otolaryngology 330 Jake Alexander Blvd West Suite 101, Salisbury, NC 28147 2006-12-28
1720174162 Michael Steven Binder Chiropractor 2124 Statesville Blvd, Salisbury, NC 28147 2006-10-05
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043677727 Concepts of Independence LLC. Residential Treatment Facility, Emotionally Disturbed Children 530 E. Fisher Street, Salisbury, NC 28144 2016-01-26
1588890933 Quality Care Developmental Services Inc. Residential Treatment Facility, Emotionally Disturbed Children 425 Mirror Lake Road, Salisbury, NC 28146-8374 2009-05-29
1043355761 Quality Care Developmental Services Inc. Residential Treatment Facility, Emotionally Disturbed Children 301 Harrel St, Salisbury, NC 28144-5868 2007-02-20
1083767669 Quality Care Developmental Services Inc. Residential Treatment Facility, Emotionally Disturbed Children 328 Old Concord Rd, Salisbury, NC 28144-5532 2007-01-18
1164584033 New Hope Residential Services,inc. Residential Treatment Facility, Emotionally Disturbed Children 204 Partee St, Salisbury, NC 28144-4049 2006-12-15
1740340421 Bridging To Success Residential Treatment Facility, Emotionally Disturbed Children 223 West 12th, Salisbury, NC 28144-3507 2006-12-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023617255 Creative Helping Hands LLC Residential Treatment Facility, Emotionally Disturbed Children 478 Green Lake Rd, Rockingham, NC 28379-7850 2020-10-19
1457998627 Re Health Group Residential Treatment Facility, Emotionally Disturbed Children 1102 Groves St, Kings Mountain, NC 28086-2232 2019-12-05
1821631532 Marquita Latrice Walls Residential Treatment Facility, Emotionally Disturbed Children 1565 Longbranch Rd, Grover, NC 28073-9599 2019-10-25
1699233866 A Brighter Path LLC Residential Treatment Facility, Emotionally Disturbed Children 120 Jetter Rd, Grover, NC 28073-9687 2019-03-06
1821562224 Carter Clinic, Pa Residential Treatment Facility, Emotionally Disturbed Children 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 2019-01-18
1659842607 Gervonia Robinson Residential Treatment Facility, Emotionally Disturbed Children 1714 Aster Ln, Gastonia, NC 28054-8303 2018-12-16
1679058440 Miracle Houses Inc Residential Treatment Facility, Emotionally Disturbed Children 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 2018-09-27
1174048078 A Safe Place Community Housing, LLC Residential Treatment Facility, Emotionally Disturbed Children 2049 Highland St, Charlotte, NC 28208-4909 2017-08-11
1104346881 Inspiration for Us Residential Treatment Facility, Emotionally Disturbed Children 1205 W Mountain St, Kernersville, NC 27284-2173 2017-06-22
1740720036 New Place, Inc. Residential Treatment Facility, Emotionally Disturbed Children 5419 Twin Ln, Charlotte, NC 28269-4635 2017-03-06
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Competitor

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City SALISBURY
Zip Code 28147

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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