Organization
LIFE REJUVENATED USA, LLC
Active
Organization
LIFE REJUVENATED USA, LLC
Active
Other names
Life Rejuvenated
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON MITTAL MD (PRESIDENT)
(507) 363-9367
Entity
Organization
Contact information
Practice address
1935 COUNTY ROAD B2 W STE 74, ROSEVILLE, MN 55113-2722
(800) 583-5290
Mailing address
1675 VILLAGE TRL E UNIT 6, MAPLEWOOD, MN 55109-5820
(507) 363-9367
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up