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Revive Health and Wellness, LLC

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Company Details

Name: Revive Health and Wellness, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 02 Aug 2022 (3 years ago)
Business ID: 1351694
ZIP code: 39564
County: Jackson
State of Incorporation: MISSISSIPPI
Principal Office Address: 2112 Bienville Blvd, Suite M-1, Ocean SpringsOcean Springs, MS 39564

Agent

Name Role Address
LEGALINC Corporate Services Inc Agent 4780 1-55 N, SUITE 100, JACKSON, MS 39211

Member

Name Role Address
Traci J White Member 17804 RIverwalk Drive, Vancleave, MS 39565

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
WZLKR5GPJ1G7
UEI Expiration Date:
2025-08-25

Business Information

Activation Date:
2024-08-28
Initial Registration Date:
2022-10-03

National Provider Identifier

NPI Number:
1255068425
Certification Date:
2022-08-06

Authorized Person:

Name:
TRACI J WHITE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-04-07 Annual Report For Revive Health and Wellness, LLC
Annual Report LLC Filed 2024-04-08 Annual Report For Revive Health and Wellness, LLC
Annual Report LLC Filed 2023-03-14 Annual Report For Revive Health and Wellness, LLC
Amendment Form Filed 2023-02-13 Amendment For Revive Health and Wellness, LLC
Formation Form Filed 2022-08-02 Formation For Revive Health and Wellness, LLC

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Date of last update: 30 May 2025

Sources: Company Profile on Mississippi Secretary of State Website