| Revive Behavioral Therapy LLC | |
|
4715 Charles Partin Dr Parrish FL 34219-1243 | |
| (857) 500-3381 | |
| Not Available |
| Full Name | Revive Behavioral Therapy LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4715 Charles Partin Dr, Parrish, Florida |
| Authorized Official Name and Position | Kevin Douglas Kent (BCBA) |
| Authorized Official Contact | 8575003381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Behavioral Therapy LLC 4715 Charles Partin Dr Parrish FL 34219-1243 Ph: (857) 500-3381 | Revive Behavioral Therapy LLC 4715 Charles Partin Dr Parrish FL 34219-1243 Ph: (857) 500-3381 |
| NPI Number | 1699591271 |
|---|---|
| Provider Enumeration Date | 11/27/2024 |
| Last Update Date | 11/27/2024 |
| Certification Date | 11/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699591271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
| 261Q00000X | Clinic/center | () | Secondary |
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