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General NPI Number Information
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NPI Number | 1407724024
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Entity Type | Organization
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Legal Business Name | REVIVE HEALTH SERVICES INC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2832 PRISCILLA ST
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City | RIVERSIDE
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State | CA
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Zip | 92506-4313
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Country | US
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Telephone | 951-522-1425
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Fax | 951-900-6169
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Provider Business Mailing Address
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Address Line | 18506 MOSS RD
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City | RIVERSIDE
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State | CA
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Zip | 92508-8750
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Country | US
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Telephone | 951-522-1425
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Fax | 951-900-6169
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SAHER CHOUDRY
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Credential |
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Telephone | 951-522-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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