Revival Recovery Center Staffing LLC
Nurse Practitioner, Family in Highland, MI. Organization (NPI-2).
NPI number1184398331
StatusActive
Last updated in NPPESMay 5, 2025
Details
- NPI
- 1184398331
- Entity type
- Organization (NPI-2)
- Legal business name
- Revival Recovery Center Staffing LLC
- Organization subpart
- No
- Enumeration date
- Aug 2, 2021
- Certification date
- May 5, 2025
- Last updated
- May 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Other names
- Revival Recovery Center Staffing (Doing Business As)
Practice location
208 W Highland Rd Ste 102Highland, MI 48357-4574
Phone 833-773-8482 · Fax 810-775-0303
Mailing address
208 W Highland Rd Ste 102Highland, MI 48357-4574
Phone 833-773-8482 · Fax 810-775-0303
Other practice locations
5797 Felske Dr Ste 300
Brighton, MI 48116-9505
Brighton, MI 48116-9505
Phone 833-773-8482 · Fax 810-775-0303
Authorized official
Lisa A Perna
Owner, Authorized Official
2489497177
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Other Family Nurse Practitioner providers in Highland, MI
- Mallory Deel, FNP-BCNPI 1790382463
- Lisa A Perna, FNPNPI 1114298700
- Denise Rocio Popovich, FNP-BCNPI 1932721719
- Kaitlynn Denise Tolonen, FNP-CNPI 1346056892
- Nicole Michelle Wendel, NP-CNPI 1326545369
All 6 Family Nurse Practitioner providers in Highland · All 310 providers in Highland
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