J-Revival LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

J-REVIVAL LLC

Practice address

4391 Garden TRL
Eagan, MN 55123-1756

Phone

(689) 242-0854

NPI assigned

Apr 25, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jewell Reichenberger, M.ED

Title

Ceo

Phone

(689) 242-0854

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1013705698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4391 GARDEN TRL",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231756",
            "telephone_number": "689-242-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4391 GARDEN TRL",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231756",
            "telephone_number": "689-242-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J-REVIVAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-25",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "REICHENBERGER",
        "authorized_official_first_name": "JEWELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "689-242-0854",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Islas Arcega
• Fardowsa Mohamud Ismail
• Mirna Ahmed Ismail
• Sadio Ismail, RN
• Mohamed Abdullahi Isse
• Korie Jackson
• Dustin Jacob, LICSW
• Leah Gail Jacob, LICSW
• Veronica Jacobsen, CD(DONA), LCCE, CLC
• Aaron Jacobson, D.C.

• In Home Supportive Care Agency in Eagan, MN
• Providers in Eagan, MN by specialty
• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.