Revital Retreat, Llc

LBN: Revital Retreat, Llc
Revital Retreat, Llc is an health care organization with primary practice located at 371 Hoes Ln Ste 200 , Piscataway NJ 08854-4143. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Revital Retreat, Llc can be contacted via phone (732) 660-8029, or through Javier, Evelyn via phone (732) 589-9388.

Contact Information

Primary practice address
371 Hoes Ln Ste 200 Piscataway NJ 08854-4143
Phone: (732) 660-8029
Fax: (732) 358-2921
Website:
Map and Directions
Authorized official contact:
Name: Javier, Evelyn Advanced Practice Registered Nurse (APRN)
Phone: (732) 589-9388

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X

Profile Details

NPI number 1366169989
LBN Legal business name Revital Retreat, Llc
DBA Doing business as
Authorized official Javier, Evelyn Advanced Practice Registered Nurse (APRN)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2022
Last updated Oct 25th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366169989 NPPES
New Jersey MEDICAID 1881653608

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