| Revive and Thrive Treatment Centers | |
|
72 Greene St Cumberland MD 21502-2933 | |
| (301) 682-2047 | |
| Not Available |
| Full Name | Revive and Thrive Treatment Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 72 Greene St, Cumberland, Maryland |
| Authorized Official Name and Position | Patrick Eskew (CEO) |
| Authorized Official Contact | 2022883400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive and Thrive Treatment Centers 915 Toll House Ave Ste 207 Frederick MD 21701-5901 Ph: (301) 732-6300 | Revive and Thrive Treatment Centers 72 Greene St Cumberland MD 21502-2933 Ph: (301) 682-2047 |
| NPI Number | 1356165740 |
|---|---|
| Provider Enumeration Date | 11/12/2024 |
| Last Update Date | 09/09/2026 |
| Certification Date | 09/09/2026 |
| Medicare PECOS PAC ID | 6901332246 |
|---|---|
| Medicare Enrollment ID | O20241210001113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356165740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Mary Jo Cannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619216835 PECOS PAC ID: 6204130750 Enrollment ID: I20160204000199 |
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