| Name: | Revive Counseling, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 09 Jun 2021 (3 years ago) (Companies founded in June 2021) |
| Entity Number: | 000-866-654 |
| Register Number: | 000866654 |
| ZIP code: | 35802 (Companies in Madison, 35802) |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 600 BOULEVARD SOUTH SW, SUITE 104JHUNTSVILLE, AL 35802 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063082840 | 2021-06-25 | 2021-06-25 | 9238 MADISON BLVD STE 116, MADISON, AL, 357589112, US | 9238 MADISON BLVD STE 116, MADISON, AL, 357589112, US | |||||||||||||||
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| Phone | +1 920-948-4535 |
| Fax | 2565423289 |
Authorized person
| Name | AMBER DALLMAN |
| Role | THERAPIST/OWNER |
| Phone | 9209484535 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role |
|---|---|
| USCA, INC. | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
