Revival Collaborative LLC
NPI #1407515620 in Bentonville, Arkansas
Provider Information
- NPI Number
- 1407515620
- Entity Type
- Organization
- Organization Name
- Revival Collaborative LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Dec 15, 2021
- Last Updated
- Dec 15, 2021
Practice Location
- Address
- 3700 MEDICAL CENTER PKWY
- City
- Bentonville
- State
- Arkansas
- ZIP Code
- 72712-3222
- Phone
- (479) 721-2110
Authorized Official
- Name
- ZACH S HEDGES, LPC
- Title
- OWNER
- Phone
- (479) 721-2110
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