Revived Medical Spa Llc

LBN: Revived Medical Spa Llc
Revived Medical Spa Llc is an health care organization with primary practice located at 350 Hillgrove Dr , Holly Springs GA 30114-8601. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Revived Medical Spa Llc can be contacted via phone (404) 551-6686, or through Kennedy, Tarsha via phone (678) 559-2301.

Contact Information

Primary practice address
350 Hillgrove Dr Holly Springs GA 30114-8601
Phone: (404) 551-6686
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kennedy, Tarsha Nurse Practitioner (NP)
Phone: (678) 559-2301

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1538837737
LBN Legal business name Revived Medical Spa Llc
DBA Doing business as
Authorized official Kennedy, Tarsha Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2021
Last updated Sep 1st, 2021 - about 4 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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