LIFE REVIVAL LLC
NPI 1023701067
Community/Behavioral Health in Philadelphia, PA

Q: What is Life Revival LLC's NPI number?

The NPI number for Life Revival LLC is 1023701067. It was assigned to this organization in the NPPES registry on May 26, 2023. The provider is also known as Life Revival, LLC.

Q: What is Life Revival LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Q: When was this NPI record last updated?

The NPPES record for Life Revival LLC was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2023

6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149(267) 577-7747 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2025, May 26, 2023 (2 updates tracked since 2023).

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About Life Revival Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE REVIVAL LLC (NPI 1023701067) is a healthcare organization registered as a community/behavioral health in Philadelphia, Pennsylvania and active in the NPI registry since May 2023. The organization lists Daniel Lee, Director, as its authorized official.

NPPES Registry Identity

NPI1023701067

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameLIFE REVIVAL LLC

Location Address6404 ROOSEVELT BLVDPhiladelphia, PA 19149-2943

Mailing Address6404 Roosevelt BlvdPhiladelphia, PA 19149-2943

Phone(267) 577-7747

Organization SubpartNo

Authorized OfficialDaniel LeeDirector · (267) 259-4558

Enumeration DateMay 26, 2023

Last NPPES UpdateFebruary 11, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 11, 2025

✔ NPI 1023701067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedPsychologist · CounselingTaxonomy 103TC1900X

Also ListedPsychologist · FamilyTaxonomy 103TF0000X

Also ListedPsychologist · PsychoanalysisTaxonomy 103TP0814X

Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X

Also ListedPsychiatry & Neurology · Geriatric PsychiatryTaxonomy 2084P0805X

Also ListedCase ManagementTaxonomy 251B00000X

Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

6404 ROOSEVELT BLVD, Philadelphia, PA 19149

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Other Names 1

Other NameLife Revival, Llc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEDIATRIC DENTAL ASSOCIATES LTD

Dentist (Pediatric Dentistry)

6404 ROOSEVELT BLVD, LOWER LEVEL
PHILADELPHIA, PA 19149

Philadelphia County (215) 743-3700

DR. STEPHEN MICHAEL GAROFALO D.C.

Chiropractor

6404 ROOSEVELT BLVD, SUITE 1C
PHILADELPHIA, PA 19149

Philadelphia County (267) 788-1789

ABOLARIN LLC

Dentist (General Practice)

6404 ROOSEVELT BLVD, 2ND FLOOR
PHILADELPHIA, PA 19149

Philadelphia County (215) 831-1023

MICHAEL ROSENBAUM DMD

Dentist (Pediatric Dentistry)