| Revive Wellness Company Llc | |
|
647 Reid Ave Lorain OH 44052-1737 | |
| (440) 541-6000 | |
| Not Available |
| Full Name | Revive Wellness Company Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 647 Reid Ave, Lorain, Ohio |
| Authorized Official Name and Position | Rebecca Serfozo (OWNER) |
| Authorized Official Contact | 4405416000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Wellness Company Llc 439 W 4th St Unit 692 Lorain OH 44052-5829 Ph: (440) 541-6000 | Revive Wellness Company Llc 647 Reid Ave Lorain OH 44052-1737 Ph: (440) 541-6000 |
| NPI Number | 1962269480 |
|---|---|
| Provider Enumeration Date | 03/01/2024 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962269480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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