OrganizationActive
Revive Recovery LLC
NPI 1215522263 · Clinic/Center · Bonita Springs, FL
Provider details
- NPI number
- 1215522263
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Christina Thomas, Owner(239) 908-9958
Specialties & taxonomies
Ambulatory Health Care Facilities
- Infusion Therapy Clinic/Center261QI0500X
Ambulatory Health Care Facilities
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3541 Bonita Bay Blvd Ste 200
Bonita Springs, FL 34134-1703
Phone: (239) 908-9958
Street-level locationGet directions
Mailing address
3541 Bonita Bay Blvd Ste 200
Bonita Springs, FL 34134-1703
Other names (DBA / former)
- Doing business as
- My Self Wellness
Registry dates
- Enumerated
- 2021-03-02
- Last updated
- 2021-03-02
- Certified
- 2021-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.