Organization · Type 2 NPI

Revivd Recovery and Wellness Fort Wayne LLC

Mental Health Clinic/Center (Including Community Mental Health Center) · Fort Wayne, IN

NPI number 1699617860 Active

Practice location

402 E Main St
Fort Wayne, IN 46802-1910

Call (260) 298-8297 Map

Fax (260) 387-6154

Specialties and licenses

TaxonomyCodeLicense
Mental Health Clinic/Center (Including Community Mental Health Center) Primary 261QM0801XNone listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

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About NPI 1699617860

Revivd Recovery and Wellness Fort Wayne LLC's National Provider Identifier is 1699617860, issued on Apr 7, 2026. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Fort Wayne, IN. The record was last updated on Apr 7, 2026.