Revive Hydration Spa Llc-S

LBN: Revive Hydration Spa Llc-S
Revive Hydration Spa Llc-S is an health care organization with primary practice located at 5650 S Franklin Rd Ste 300C , Indianapolis IN 46239-8620. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Revive Hydration Spa Llc-S can be contacted via phone (317) 245-7353, or through Archer, Jane via phone (317) 245-7353.

Contact Information

Primary practice address
5650 S Franklin Rd Ste 300C Indianapolis IN 46239-8620
Phone: (317) 245-7353
Fax: (317) 527-9214
Website:
Map and Directions
Authorized official contact:
Name: Archer, Jane Nurse Practitioner (NP)
Phone: (317) 245-7353

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X

Profile Details

NPI number 1225627920
LBN Legal business name Revive Hydration Spa Llc-S
DBA Doing business as
Authorized official Archer, Jane Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2021
Last updated Jan 16th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225627920 NPPES
Indiana MEDICAID 1619237476

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