Organization
REVIVING LIFE MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE EKEH (APN)
(908) 361-7498
Entity
Organization
Contact information
Practice address
305 ROSEBERRY ST, PHILLIPSBURG, NJ 08865-1600
(908) 361-7498
Mailing address
305 ROSEBERRY ST, PHILLIPSBURG, NJ 08865-1600
(908) 361-7498
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
02/08/2024
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