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Contact Information

REVIVE LIFE MINISTRIES, INC.
920 FREDERICA ST STE 105
OWENSBORO, KY42301-3076
 Phone: 270-215-1827
 Fax: 270-215-5747
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for REVIVE LIFE MINISTRIES, INC.

NPI # 1205349586
LBN Legal business name REVIVE LIFE MINISTRIES, INC.
Authorized official WILLIAM GAMMON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/09/2017
Last updated 12/08/2018 - About 7 years ago
Identifiers
KY License # 18402
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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