| Revitalize Counseling Services Llc | |
|
2401 Woodland Rd Manchester NJ 08759-6135 | |
| (848) 459-5943 | |
| Not Available |
| Full Name | Revitalize Counseling Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2401 Woodland Rd, Manchester, New Jersey |
| Authorized Official Name and Position | Dana M Gibilisco (CEO) |
| Authorized Official Contact | 8484595943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalize Counseling Services Llc 2401 Woodland Rd Manchester NJ 08759-6135 Ph: (848) 459-5943 | Revitalize Counseling Services Llc 2401 Woodland Rd Manchester NJ 08759-6135 Ph: (848) 459-5943 |
| NPI Number | 1184132094 |
|---|---|
| Provider Enumeration Date | 01/12/2018 |
| Last Update Date | 01/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184132094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00555800 (New Jersey) | Primary |
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