REVIVAL MENTAL HEALTH LLC
NPI 1922721083
Community Based Residential Treatment Facility, Mental Illness in Fountain Valley, CA
NPI Status: Active since September 23, 2022
Contact Information
9879 HAMILTON AVE
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (949) 606-4681
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 05D2288290
- CLIA Cert. Type: Other - MENTAL HEALTH TRANS FACIL
- CLIA Exp. Date: 08-22-2027
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 Fountain Valley, California operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1922721083 assigned on September 2022. 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
- 1922721083
- Provider Name
- REVIVAL MENTAL HEALTH LLC
- Entity Type
- Organization
- Location Address
- 9879 HAMILTON AVE FOUNTAIN VALLEY, CA 92708
- Location Phone
- (949) 606-4681
- Mailing Address
- 9879 HAMILTON AVE FOUNTAIN VALLEY, CA 92708
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-23-2022
- Last Update Date
- 01-10-2024
- Code Navigator
Location Map
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.
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
- 05D2288290
- Facility Type
- Other - MENTAL HEALTH TRANS FACIL
- Certificate Effective Date
- August 23, 2025
- Certificate Expiration Date
- August 22, 2027
- 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 1922721083, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922721083, enumerated as an "organization" on September 23, 2022.
The provider is located at 9879 HAMILTON AVE FOUNTAIN VALLEY, CA 92708 and the phone number is (949) 606-4681.
Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
