Reviving Life Mental Health Services LLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

REVIVING LIFE MENTAL HEALTH SERVICES LLC

Practice address

305 Roseberry St
Phillipsburg, NJ 08865-1600

Phone

(908) 361-7498

NPI assigned

Sep 12, 2023

Last updated

Feb 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pauline EkehNPI 1033860234

Title

Apn

Phone

(908) 361-7498

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pauline Ekeh

  • Psychiatric/Mental Health Nurse Practitioner
  • Phillipsburg, NJ
  • NPI 1033860234
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1669259735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 ROSEBERRY ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651600",
            "telephone_number": "908-361-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ROSEBERRY ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651600",
            "telephone_number": "908-361-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVING LIFE MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "EKEH",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "908-361-7498"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Remde, M.D.
• Kelly Dawn Repka, PT
• Rez Padpad Resano, PT
• Retina Specialists of New Jersey LLC
• Manasi Revankar, D.O.
• Shiva Rezvanian, M.D
• Marquetta Richardson
• Rise Ventures Corp (Synergy HomeCare of Phillipsburg)
• River Run Wellness Corp
• Ashley Jean Marie Rivera, PT, DPT, ATP

• Psychiatric/Mental Health Registered Nurse in Phillipsburg, NJ
• Providers in Phillipsburg, NJ by specialty
• Psychiatric/Mental Health Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.