Revive Recovery · Community/Behavioral Health Agency

18990 Westbay Ln, Waterville, MN 56096-4138

Overview

Revive Recovery is a Community/Behavioral Health Agency (organization) practicing in Waterville, Minnesota. The National Provider Identifier (NPI) is #1982547295, which was assigned on April 11, 2026, and the registration record was last updated on April 11, 2026. The practitioner's main practice location is at 18990 Westbay Ln, Waterville, MN 56096-4138; the contact telephone number is 5074561633. The primary taxonomy of Revive Recovery is Community/Behavioral Health Agency (251S00000X). The authorized official for Revive Recovery is Karen Kay Theissen (Board of Dir - Secretary/Treasurer).

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.

Provider Information

NPI 1982547295
Entity Type Organization
Organization Name REVIVE RECOVERY
Provider Name REVIVE RECOVERY
Practice Address 18990 Westbay Ln
Waterville
MN 56096-4138
Practice Telephone 5074561633
Mailing Address 18990 Westbay Ln
Waterville
MN 56096-4138
Mailing Telephone 5074561633
Certification Date 2026-04-11
Enumeration Date 2026-04-11
Last Update Date 2026-04-11
Is Organization Subpart N

Authorized Official Information

Official Name KAREN KAY THEISSEN
Official Title BOARD OF DIR - SECRETARY/TREASURER
Telephone 5074561633

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N251B00000XCase Management
Y251S00000XCommunity/Behavioral Health

Taxonomy Information

Primary Taxonomy

Code 251S00000X
Taxonomy Community/Behavioral Health Agency
Classification Community/Behavioral Health
Grouping Agencies
Definition: 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.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition, 1/1/2021: modified definition]

Other Taxonomy

Code 251B00000X
Taxonomy Case Management Agency
Classification Case Management
Grouping Agencies
Definition: An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified]

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Flexpath Recovery LLC 2323 Lake Club Dr Ste 304a, Columbus, OH 43232-3198Community/Behavioral Health Agency2026-06-06
Bluprint Mental Health Services 636 Broad St Apt 100, Perryville, MD 21903-2814Community/Behavioral Health Agency2026-06-05
Nurturing Minds Health and Wellness LLC 9026 Liberty Rd Ste 102, Randallstown, MD 21133-3900Community/Behavioral Health Agency2026-06-05
Aaron Braun, Licensed Clinical Social Worker, Therapeutic Services Inc. 4319 Piedmont Ave Fl 2, Oakland, CA 94611-4755Community/Behavioral Health Agency2026-06-06
Together We Thrive Group, LLC 347 Clark Rd, Wilsons, VA 23894-2062Community/Behavioral Health Agency2026-06-05
Katherine Prodanovich Licensed Professional Clinical Counselor, Corp. 22922 Los Alisos Blvd Ste K-345, Mission Viejo, CA 92691-2856Community/Behavioral Health Agency2026-06-05
Integrated Life Services LLC 700 S Sycamore St Ste 8, Petersburg, VA 23803-5803Community/Behavioral Health Agency2026-06-05
Bay Area Community Services, Inc. 345 E Travis Blvd, Fairfield, CA 94533-3958Community/Behavioral Health Agency2026-06-05
Lily Flower of The Valley 2648 International Blvd Ste 402, Oakland, CA 94601-1580Community/Behavioral Health Agency2026-06-06
Empowered Living Solutions& Wellness LLC 3408 Plover Run Trl, Pflugerville, TX 78660-3628Community/Behavioral Health Agency2026-06-06
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Location Information

Street Address 18990 WESTBAY LN
City WATERVILLE
State MN
Zip Code 56096-4138
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Kathryn Johnson 201 Paquin St E Apt 4, Waterville, MN 56096-1489Registered Dietitian2026-01-15
William A Struve Ltd 204 4th St N, Waterville, MN 56096-1548General Practice Dentistry2011-08-25
Sunrise Products of Waterville Minnesota Inc 215 Hoosac St W, Waterville, MN 56096Durable Medical Equipment & Medical Supplies2008-12-01
Bergs Pharmacy Inc 103 3rd St S, Waterville, MN 56096-1444Long Term Care Pharmacy2006-05-02
Kristin Mertins · Kritin Stangler 404 Paquin St E, Waterville, MN 56096-1532Registered Nurse2020-08-11
The Evangelical Lutheran Good Samaritan Society 205 1st St N, Waterville, MN 56096-1156Nursing Facility Supplies (DME)2005-10-26
Angela Ann Dahlberg 500 Paquin St E, Waterville, MN 56096-1533Speech-Language Pathologist2026-04-22
Annette Benson 1059 Maple Dr, Waterville, MN 56096-1234Health Educator2025-05-28
William Allen Struve 204 N 4th Street, Waterville, MN 56096General Practice Dentistry2006-12-28
Marilyn K. Waldschmidt 212 Lake St E, Waterville Clinic - Mayo Health System, Waterville, MN 56096-1450Family Medicine Physician2006-01-30
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.