Organization Name: | REVIVE & THRIVE THERAPY LLC |
NPI Number: | 1205217809 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARLENE VIEIRA ANJOS (MEMBER) |
Mailing Address: | 173 E Grant Ave Roselle Park |
State: | NJ US |
Postal Code: | 072042026 |
Phone Number: | 9083155947 |
Fax Number: | 9083445537 |
NPI Enumeration Date: | 06/09/2015 |
NPI Last Update Date: | 06/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC05485900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |