Organization
REVIVE HYDRATION SPA LLC
Active
Other names
Revive Hydration LLC-S, Revive RX
Organization subpart
No
Provider details
NPI number
Authorized official
JANE ARCHER NP (OWNER)
(317) 245-7353
Entity
Organization
Contact information
Practice address
5650 S FRANKLIN RD STE 300C, INDIANAPOLIS, IN 46239-8620
(317) 245-7353
(317) 527-9214
Mailing address
5650 S FRANKLIN RD STE 300C, INDIANAPOLIS, IN 46239-8620
(317) 245-7353
(317) 527-9214
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619237476
—
IN
Enumeration date
01/16/2021
Last updated
02/04/2025
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