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NPI Code Detail

MEDICARE: REVIVE WITHIN THERAPY SERVICES LLC

MEDICARE: REVIVE WITHIN THERAPY SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1508712811
Entity Type Code : Organization
Provider Name (Legal Business Name) : REVIVE WITHIN THERAPY SERVICES LLC
Provider Business Mailing Address
First Line : 6310 PADDOCK LN
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2735
Country : US
Telephone Number : 810-221-1384
Fax Number :
Provider Business Practice Location Address
First Line : 4604 N SAGINAW RD STE N6
Second Line :
City : MIDLAND
State : MI
Zip : 48640-2387
Country : US
Telephone Number : 810-221-1384
Fax Number :
Authorized Official
Title or Position : OWNER/OUTPATIENT THERAPIST
Name : SAMANTHA HUEBLER-DAVIS
Credential : LMSW, CAADC, ADS
Telephone Number : 248-921-6111
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “REVIVE WITHIN THERAPY SERVICES LLC ” Practice Location

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