# J-REVIVAL LLC

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

## Provider details

- **NPI number:** 1013705698
- **Authorized official:** JEWELL REICHENBERGER M.ED (CEO)
- **Authorized official phone:** (689) 242-0854

## Contact information

- **Practice address:** 4391 GARDEN TRL, EAGAN, MN 55123-1756
- **Practice address phone:** (689) 242-0854
- **Mailing address:** 4391 GARDEN TRL, EAGAN, MN 55123-1756
- **Mailing address phone:** (689) 242-0854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/25/2025
- **Last updated:** 04/02/2026