| Psyche Revive Llc | |
|
4 Swimming River Rd Ste 101 Lincroft NJ 07738-1727 | |
| (646) 708-3846 | |
| Not Available |
| Full Name | Psyche Revive Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4 Swimming River Rd Ste 101, Lincroft, New Jersey |
| Authorized Official Name and Position | Stephen Jaeger (FOUNDING PHYSICIAN) |
| Authorized Official Contact | 3477215590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psyche Revive Llc 30 La Jolla Ct Holmdel NJ 07733-2520 Ph: (347) 721-5590 | Psyche Revive Llc 4 Swimming River Rd Ste 101 Lincroft NJ 07738-1727 Ph: (646) 708-3846 |
| NPI Number | 1376219402 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 08/18/2021 |
| Certification Date | 08/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376219402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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