NPI 1003231820

Revive Detox Center

Organisation Substance Abuse Rehabilitation Facility Port Saint Lucie, FL

Practice location

Address: 8489 S Federal Hwy # 1 (s. Federal Highway) Ste.16, Port Saint Lucie, FL 34952-3360
Phone: (772) 828-6992
Mailing address: 344 SW Quiet Woods, Port Saint Lucie, FL 34953-8230

Authorised official

Name: Rafael A. Hernandez
Title: Owner
Phone: (772) 828-6992

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Florida →

Registry record

NPI: 1003231820
Entity type: Organization
NPI issued: 3 Mar 2014
Record last updated: 7 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.