THE REJUVENATION SPACE LLC (NPI# 1386273571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386273571 |
| Entity Type | Organization |
| Organization Name | THE REJUVENATION SPACE LLC |
| Practice Address |
230 40th St Irvington NJ 07111-1149 |
| Practice Telephone | 6466335595 |
| Mailing Telephone | 6466335595 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-15 |
| Authorized Official Name | MRS. CHRYSTAL RENEE ALLEN (BUSINESS OWNER) |
| Authorized Official Telephone | 6466335595 |
| Authorized Official Credential | LICENSED COUNSEL |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
230 40TH ST |
| City | IRVINGTON |
| State | NJ |
| Zip Code | 07111-1149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548871163 | Le Choix Home Care LLC | Home Health | 1395-1399 Clinton Ave, Irvington, NJ 07111 | 2020-08-17 |
| 1528532447 | All America Medical Day Care | Custodial Care Facility | 141 Coit St, Irvington, NJ 07111 | 2019-01-14 |
| 1548737240 | Irvington Adult Day Care Center | Clinic/Center | 62-70 Howard Street, Irvington, NJ 07111 | 2018-10-31 |
| 1245754084 | Soul House Cruber Wellness Center | Counselor | 1144 Clinton Avenue, Irvington, NJ 07111 | 2017-08-02 |
| 1689194094 | Anthony Ijehsedeh | Nurse Practitioner | 12 Krotik Place, Irvington, NJ 07111 | 2017-06-27 |
| 1467993246 | Sia Kendema | Respite Care | 102 Paine Avenue, Irvington, NJ 07111 | 2017-03-14 |
| 1316482078 | Walgreen Co | Pharmacy | 810 Springfield Ave, Irvington, NJ 07111 | 2017-01-04 |
| 1679023915 | Lyons Pharmacy | Pharmacy | 471 Lyons Ave #79, Irvington, NJ 07111 | 2016-10-11 |
| 1952759276 | Sabreehouse | Community/Behavioral Health | 74 Welland Avenue, Irvington, NJ 07111 | 2016-05-26 |
| 1447624184 | Marius Nzo Yonkeu | Pharmacist | 19 Bruen Ave Apt C1, Irvington, NJ 07111 | 2015-11-18 |
| Find all providers in zip 07111 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548891187 | Elsa E Thompson | Counselor | 520 Nye Ave, Irvington, NJ 07111-3511 | 2020-02-02 |
| 1053963827 | Bernadine Akunna Nwoga II | Counselor | 63 Kuna Ter, Irvington, NJ 07111-2941 | 2019-07-11 |
| 1407242753 | Connie Douglas Lcsw | Counselor | 49 Main St Apt 1, Irvington, NY 10533-1537 | 2015-04-14 |
| 1427201565 | David L Matthew | Counselor | 184 S Buckhout St, Irvington, NY 10533-2207 | 2008-11-03 |
| 1720295173 | Naomi Nunokawa Fensterstock | Counselor | 120 N Broadway, Apt 8b, Irvington, NY 10533-1239 | 2007-05-16 |
| 1639645179 | Shelleyswayllc | Counselor | 50 Union Ave Ste 804b, Irvington, NJ 07111-5221 | 2018-10-23 |
| 1023556909 | Amber Dasilva | Counselor | 49 Main St, Apt. #1, Irvington, NY 10533-1568 | 2017-02-10 |
| 1750711057 | Sharmy Pierre-louis | Counselor | 260 Nesbit Ter, Irvington, NJ 07111-1773 | 2013-11-22 |
| 1699042663 | Schenike S Massie | Counselor | 21 Maple Ave, Irvington, NJ 07111-4323 | 2011-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366042525 | Haydee Pimentel | Counselor | 1306 Fox Run Dr, Plainsboro, NJ 08536-2665 | 2020-10-27 |
| 1750981197 | Timothy Lowe | Counselor | 240 E Westfield Ave Apt C18, Roselle Park, NJ 07204-2326 | 2020-10-26 |
| 1417556069 | Nancy W Bodnar | Counselor | 52 Long Hill Rd, Long Valley, NJ 07853-3074 | 2020-10-23 |
| 1497354260 | Michele Marie Bruce | Counselor | 5 Horizon Rd Apt 306, Fort Lee, NJ 07024-6627 | 2020-10-22 |
| 1851990220 | Tzvi Friedman | Counselor | 308 South Pkwy, Clifton, NJ 07014-1223 | 2020-10-18 |
| 1285232702 | Guided Growth Therapy, LLC | Counselor | 230 Kings Hwy E Ste 140, Haddonfield, NJ 08033-1907 | 2020-10-16 |
| 1306444518 | Mindful Health Tbi Center Inc | Counselor | 37 Hanover Rd, Marlton, NJ 08053-1905 | 2020-10-12 |
| 1952908261 | Kathryn Vetrano | Counselor | 12 Lakeview St, River Edge, NJ 07661-1720 | 2020-10-08 |
| 1477150324 | Aloha Counseling and Support Services, LLC | Counselor | 5 Madison Ln, Sicklerville, NJ 08081-4410 | 2020-10-05 |
| 1801403175 | Visions and Pathways | Counselor | 49 Brahma Avenue, Bridgewater, NJ 08807 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.