# REJUVENATE RESIDENTIAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003760679
- **Authorized official:** DR. DOMINYSE DAVIS DNP, APRN, FNP PMHNC (OWNER)
- **Authorized official phone:** (317) 985-3580

## Contact information

- **Practice address:** 1904 E 22ND ST, MUNCIE, IN 47302-5466
- **Practice address phone:** (765) 273-3391
- **Mailing address:** 5112 N HICKORY RD, MUNCIE, IN 47303-1074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2026
- **Last updated:** 02/23/2026