Provider Demographics
NPI:1104611755
Name:REVIVE HOPE BEHAVIORAL HEALTHCARE PLLC
Entity type:Organization
Organization Name:REVIVE HOPE BEHAVIORAL HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ODINMAH
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:832-264-4709
Mailing Address - Street 1:19907 ROYCROFT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4003
Mailing Address - Country:US
Mailing Address - Phone:832-264-4709
Mailing Address - Fax:
Practice Address - Street 1:19907 ROYCROFT LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4003
Practice Address - Country:US
Practice Address - Phone:832-264-4709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No251S00000XAgenciesCommunity/Behavioral Health