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REVIVE WELLNESS GROUP
NPI 1922868827
Substance Abuse Rehabilitation Facility in Tarzana, CA

Active since March 19, 2024CLIA 05D2313603 · Waiver
5401 VANALDEN AVE, TARZANA, CA 91356(818) 634-7091 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Revive Wellness Group NPPES

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

REVIVE WELLNESS GROUP (NPI 1922868827) is a healthcare organization registered as a substance abuse rehabilitation facility in Tarzana, California and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through November 3, 2026 and lists Kevork Shahinian, Cfo, as its authorized official.

NPPES Registry Identity

NPI1922868827
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameREVIVE WELLNESS GROUP
Location Address5401 VANALDEN AVETarzana, CA 91356-3129
Mailing Address9528 Topanga Canyon BlvdChatsworth, CA 91311-4011
Phone(818) 634-7091
Organization SubpartNo
Authorized OfficialKevork ShahinianCfo · (818) 634-7091
Enumeration DateMarch 19, 2024
Last NPPES UpdateOctober 4, 2024
NPPES CertifiedSeptember 24, 2024
✔ NPI 1922868827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X
5401 VANALDEN AVE, Tarzana, CA 91356
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2313603

Revive Wellness Group · Tarzana, CA
Active · expires Nov 3, 2026
CLIA Number05D2313603
Laboratory TypeDrug And Alcohol Treatmen
Certificate Effective DateNovember 4, 2024
Certificate Expiration DateNovember 3, 2026
Laboratory DirectorCourtney Scott
Laboratory Phone(818) 395-7137
Laboratory LocationRevive Wellness Group5401 Vanalden Ave, Tarzana, CA 91356
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revive Wellness Group's NPI number?

The NPI number for Revive Wellness Group is 1922868827. It was assigned to this organization in the NPPES registry on March 19, 2024.

Where is Revive Wellness Group located?

Revive Wellness Group is located at 5401 Vanalden Ave, Tarzana, CA 91356. The listed phone number is (818) 634-7091.

What is Revive Wellness Group's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Revive Wellness Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2313603) is associated with this NPI, valid through November 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Revive Wellness Group was last updated on October 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.