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Revive Roots, Pllc
Multi-Specialty Clinic/Center in Minneapolis, Minnesota
NPI 1548800915

Revive Roots, Pllc is a Multi-Specialty Clinic/Center based in Minneapolis, MN and is specialized in Multi-Specialty. Revive Roots, Pllc practices in Minneapolis, MN. The NPI Number for Revive Roots, Pllc is 1548800915 and holds a License No. (Minnesota).

The current practice location address for Revive Roots, Pllc is 3440 Portland Ave, Minneapolis, MN and can be reached out via phone at 612-990-8172.

Location: 3440 Portland Ave, Minneapolis, MN, 55407-4861
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1548800915
Provider Name
Revive Roots, Pllc
Credential
Provider Entity Type
Organization
Address
3440 Portland Ave, Minneapolis, MN, 55407-4861
Phone Number
612-990-8172
Fax Number
Provider Enumeration Date
01/13/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3440 Portland Ave
City
Minneapolis
State
Minnesota
Zip
55407-4861
Phone Number
612-990-8172
Fax Number
person
Provider Business Mailing Address Details
Address
3440 Portland Ave
City
Minneapolis
State
Minnesota
Zip
55407-4861
Phone Number
612-990-8172
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
()
Definition
Definition to come...
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