Revive Detox Center
NPI #1003231820 in Port Saint Lucie, Florida
Provider Information
- NPI Number
- 1003231820
- Entity Type
- Organization
- Organization Name
- Revive Detox Center
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Mar 3, 2014
- Last Updated
- Mar 7, 2014
Practice Location
- Address
- 8489 S FEDERAL HWY # 1
- Address 2
- (S. FEDERAL HIGHWAY) STE.16
- City
- Port Saint Lucie
- State
- Florida
- ZIP Code
- 34952-3360
- Phone
- (772) 828-6992
Authorized Official
- Name
- MR. RAFAEL A. HERNANDEZ JR.
- Title
- OWNER
- Phone
- (772) 828-6992
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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