REVIVAL MENTAL HEALTH LLC
NPI 1588435325
Community Based Residential Treatment Facility, Mental Illness in Huntington Beach, CA

NPI Status: Active since January 10, 2024

Contact Information

16252 MAGELLAN LN
HUNTINGTON BEACH, CA
ZIP 92647
Phone: (949) 776-9476

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  • Organization
  • Community Based Residential Treatment Fa...
  • CLIA Number: 05D2313615
  • CLIA Cert. Type: Ancillary Testing Site in Health Care Center
  • CLIA Exp. Date: 11-03-2026

About REVIVAL MENTAL HEALTH LLC

This page provides the complete NPI Profile along with additional information for Revival Mental Health Llc, a provider established in Huntington Beach, California operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1588435325 assigned on January 2024. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Tyler Michaelis (Managing Member)

NPI
1588435325
Provider Name
REVIVAL MENTAL HEALTH LLC
Entity Type
Organization
Location Address
16252 MAGELLAN LN HUNTINGTON BEACH, CA 92647
Location Phone
(949) 776-9476
Mailing Address
16252 MAGELLAN LN HUNTINGTON BEACH, CA 92647
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-10-2024
Last Update Date
01-10-2024
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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 Based Residential Treatment Facility, Mental Illness

Taxonomy Code
320800000X
Type
Residential Treatment Facilities
Taxonomy Description
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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

TYLER MICHAELIS

Authorized Official Title
MANAGING MEMBER
Authorized Official Phone
(949) 606-4681

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2313615
Facility Type
Ancillary Testing Site in Health Care Center
Certificate Effective Date
November 04, 2024
Certificate Expiration Date
November 03, 2026
Laboratory Director
ALEJANDRO ALVA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Revival Mental Health Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1588435325, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
5
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
8
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
2
Doubled → 4
Check
5
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 8 → 16 → 7 4 → 8 5 → 10 → 1 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 1 + 6 + 8 + 8 + 3 + 1 + 0 + 3 + 4 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1588435325.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1588435325, enumerated as an "organization" on January 10, 2024.

The provider is located at 16252 MAGELLAN LN HUNTINGTON BEACH, CA 92647 and the phone number is (949) 776-9476.

Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.