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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