Revive Life House Outpatient Center

LBN: Revive Ministries Inc
Revive Life House Outpatient Center is an health care organization with primary practice located at 800 S. Main Street Suite C., Nicholasville KY 40356-1868. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist, Physician Assistants & Advanced Practice Nursing Providers / Family. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty. Revive Ministries Inc can be contacted via phone (859) 241-5174, or through Johns, Todd via phone (859) 354-9841.

Contact Information

Primary practice address
800 S. Main Street Suite C. Nicholasville KY 40356-1868
Phone: (859) 241-5174
Fax: (859) 305-6004
Website:
Map and Directions
Authorized official contact:
Name: Johns, Todd
Phone: (859) 354-9841

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1891370185
LBN Legal business name Revive Ministries Inc
DBA Doing business as Revive Life House Outpatient Center
Authorized official Johns, Todd
Entity Organization
Organization subpart 1 No
Enumeration date Mar 17th, 2021
Last updated Nov 18th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891370185 NPPES
Kentucky MEDICAID 7100737830

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