NPI:
1427641596
Provider Name:
REVIVE THERAPY, LLC
Former Legal Business Name: BLOOM THERAPY, LLC
Classification:
Counselor - 101YP2500X
Entity Type:
Organization
Specialization: Professional
Address:
104 MAXWELL AVE STE 208
GREENWOOD, SC
ZIP 29646
Phone:
(864) 495-3131
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REVIVE THERAPY, LLC is a professional counselor in Greenwood, SC. REVIVE THERAPY, LLC NPI is 1427641596. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Bloom Therapy, Llc.
The provider's business location address is:
104 MAXWELL AVE STE 208
GREENWOOD, SC
ZIP 29646-641
Phone: (864) 495-3131
Fax: (864) 495-3132
The provider's authorized official is Nina Grace Singh .
The authorized official title is Licensed Professional Counselors and has the following contact phone number (864) 323-6414.
The enumeration date for this NPI number is 2/18/2021 and was last updated on 1/20/2022.