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Organization
LIFETRACK RESOURCES, INC.
Active
Organization
LIFETRACK RESOURCES, INC.
Active
Other names
St. Paul Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
TRIXIE ANN GOLBERG (PRESIDENT)
(651) 227-8471
Entity
Organization
Contact information
Practice address
709 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4804
(651) 227-8471
(651) 265-2318
Mailing address
709 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4804
(651) 227-8471
(651) 265-2318
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019353
PREFERRED ONE
MN
01
—
102486
UCARE - PT/OT/SP
MN
01
—
108931
UCARE - MENTAL HEALTH
MN
01
—
119905
CHOICE PLUS
MN
01
—
13112SP
BCBS - OT
MN
01
—
27779PA
BCBS - PT
MN
01
—
28605PA
BCBS - SP
MN
01
—
431M9LI
BCBS - MENTAL HEALTH
MN
01
—
505120046
MHP
MN
05
—
553476300
—
MN
01
—
5900058
MEDICA DUAL SOLUTION
MN
01
—
6400054
MEDICA CROSS OVER MEDICAR
MN
05
—
995555100
—
MN
05
—
995555101
—
MN
Enumeration date
08/02/2006
Last updated
05/30/2013
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