Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Ketamine and Wellness PC

Organization Health Service Clinic/Center · NPI 1841146214

Revive Ketamine and Wellness PC is a Health Service Clinic/Center in Lafayette, Indiana. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

210 Meijer Dr Ste C
Lafayette, IN 47905-4694
Phone: (765) 764-9305
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1841146214
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicholas Sansone — Dr · (773) 208-5872
NPI enumeratedMarch 9, 2026
Last updated in NPPESMarch 9, 2026
Certification dateMarch 9, 2026
Mailing address3040 Lake Shore Dr, Michigan City, IN 46360-1708

Other providers in Lafayette