Organization
REJUVENATING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELISA TATE (DIRECTOR)
(504) 942-7171
Entity
Organization
Contact information
Practice address
3920 OLD GENTILLY RD, NEW ORLEANS, LA 70126-4859
(504) 942-7171
(504) 942-7174
Mailing address
3920 OLD GENTILLY RD, NEW ORLEANS, LA 70126-4859
(504) 942-7171
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
8905
LA
251E00000X
Home Health Agency
8906
LA
251E00000X
Home Health Agency
Primary
8908
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114901
—
LA
05
—
1172618
—
LA
05
—
1664588
—
LA
05
—
1698717
—
LA
Enumeration date
04/11/2007
Last updated
08/06/2010
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