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Organization

REVIVE, REJUVENATE, RENEW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER REID LCSW (OWNER/OPERATOR)
(860) 960-4470
Entity
Organization

Contact information

Practice address
1 MCKAYLA DR, NEW MILFORD, CT 06776-4666
(860) 960-4470
Mailing address
1 MCKAYLA DR, NEW MILFORD, CT 06776-4666
(860) 960-4470

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
03/02/2023
Last updated
03/02/2023
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