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General NPI Number Information
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NPI Number | 1508712811
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Entity Type | Organization
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Legal Business Name | REVIVE WITHIN THERAPY SERVICES LLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 4604 N SAGINAW RD STE N6
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City | MIDLAND
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State | MI
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Zip | 48640-2387
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Country | US
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Telephone | 810-221-1384
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Fax |
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Provider Business Mailing Address
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Address Line | 6310 PADDOCK LN
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City | SAGINAW
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State | MI
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Zip | 48603-2735
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Country | US
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Telephone | 810-221-1384
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Fax |
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Authorized Official
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Title or Position | OWNER/OUTPATIENT THERAPIST
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Name | SAMANTHA HUEBLER-DAVIS
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Credential | LMSW, CAADC, ADS
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Telephone | 248-921-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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