| Revive Life | |
|
316 E Diamond Ave Gaithersburg MD 20877-3070 | |
| (206) 898-5432 | |
| Not Available |
| Full Name | Revive Life |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 316 E Diamond Ave, Gaithersburg, Maryland |
| Authorized Official Name and Position | Kayla Rojas (COMPLIANCE DIRECTOR) |
| Authorized Official Contact | 2068985432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Life 316 E Diamond Ave Gaithersburg MD 20877-3070 Ph: () - | Revive Life 316 E Diamond Ave Gaithersburg MD 20877-3070 Ph: (206) 898-5432 |
| NPI Number | 1740081223 |
|---|---|
| Provider Enumeration Date | 03/21/2025 |
| Last Update Date | 03/21/2025 |
| Certification Date | 03/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740081223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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