Organization
J-REVIVAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEWELL REICHENBERGER M.ED (CEO)
(689) 242-0854
Entity
Organization
Contact information
Practice address
4391 GARDEN TRL, EAGAN, MN 55123-1756
(689) 242-0854
Mailing address
4391 GARDEN TRL, EAGAN, MN 55123-1756
(689) 242-0854
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
04/02/2026
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