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

NPI Status: Active since May 26, 2023

Contact Information

6404 ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19149
Phone: (267) 577-7747

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  • Organization
  • Community/Behavioral Health

About LIFE REVIVAL LLC

This page provides the complete NPI Profile along with additional information for Life Revival Llc, a provider established in Philadelphia, Pennsylvania operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1023701067 assigned on May 2023. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Life Revival Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's . The authorized official of this NPI record is Dr. Daniel Lee Psyd (Director)

NPI
1023701067
Provider Legal Name
LIFE REVIVAL LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
6404 ROOSEVELT BLVD PHILADELPHIA, PA 19149
Location Phone
(267) 577-7747
Mailing Address
6404 ROOSEVELT BLVD PHILADELPHIA, PA 19149
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-26-2023
Last Update Date
02-11-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community/Behavioral Health

Taxonomy Code
251S00000X
Type
Agencies
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YM0800XBehavioral Health & Social Service Providers

Counselor
Mental Health

 
2103TC1900XBehavioral Health & Social Service Providers

Psychologist
Counseling

 
3103TF0000XBehavioral Health & Social Service Providers

Psychologist
Family

 
4103TP0814XBehavioral Health & Social Service Providers

Psychologist
Psychoanalysis

 
5103TP2701XBehavioral Health & Social Service Providers

Psychologist
Group Psychotherapy

 
61041C0700XBehavioral Health & Social Service Providers

Social Worker
Clinical

 
72084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

 
82084P0804XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Child & Adolescent Psychiatry

 
92084P0805XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Geriatric Psychiatry

 
10251B00000XAgencies

Case Management

 
11261QM0801XAmbulatory Health Care Facilities

Clinic/Center
Mental Health (Including Community Mental Health Center)

 
12261QM0850XAmbulatory Health Care Facilities

Clinic/Center
Adult Mental Health

 
13261QM0855XAmbulatory Health Care Facilities

Clinic/Center
Adolescent and Children Mental Health

 
14363LP0808XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Psychiatric/Mental Health

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. DANIEL LEE PSYD

Authorized Official Title
DIRECTOR
Authorized Official Phone
(267) 259-4558

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023701067, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 43. The final step is to find the difference between that total and the next multiple of ten (50 - 43 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 7 → 14 → 5 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 1 + 4 + 0 + 2 + 0 + 1 + 2 + 24 = 43

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 43 is 50. The difference is the calculated check digit.

50 - 43 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1023701067.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Orthodontics and Dentofacial Orthopedics)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Audiologist
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Orthodontics and Dentofacial Orthopedics)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD, LOWER LEVEL
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist
6404 ROOSEVELT BLVD, SUITE 4
PHILADELPHIA, PA 19149
Dentist (Orthodontics and Dentofacial Orthopedics)
6404 ROOSEVELT BLVD
PHILADELPHIA, PA 19149
Dentist (Pediatric Dentistry)
6404 ROOSEVELT BLVD, LOWER LEVEL
PHILADELPHIA, PA 19149
Clinic/Center (Adult Mental Health)
6404 ROOSEVELT BLVD, SUITE 1D
PHILADELPHIA, PA 19149
Nurse Practitioner (Pediatrics)
6404 ROOSEVELT BLVD, SUITE 1B
PHILADELPHIA, PA 19149
Dentist (General Practice)
6404 ROOSEVELT BLVD, 2ND FLOOR
PHILADELPHIA, PA 19149
Dentist (Orthodontics and Dentofacial Orthopedics)
6404 ROOSEVELT BLVD, 2ND FLOOR
PHILADELPHIA, PA 19149

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023701067, enumerated as an "organization" on May 26, 2023.

The provider is located at 6404 ROOSEVELT BLVD PHILADELPHIA, PA 19149 and the phone number is (267) 577-7747.

Community/Behavioral Health with taxonomy code 251S00000X.