A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Substance Abuse Disorder Rehabilitation Facility | 324500000X |
* Indicates primary specialty
| NPI Number | 1639561566 |
| Legal business name LBN |
REVIVE DETOX |
| Authorized official | MATTHEW CONLEY - (PROGRAM DIRECTOR) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 03/02/2015 |
| Last updated | 03/02/2015 - About 11 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
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1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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