LIFE REJUVENATED USA, LLC
NPI 1780251223
Point of Service in Roseville, MN

Q: What is Life Rejuvenated Usa, LLC's NPI number?

The NPI number for Life Rejuvenated Usa, LLC is 1780251223. It was assigned to this organization in the NPPES registry on June 4, 2021. The provider is doing business as Life Rejuvenated.

Q: What is Life Rejuvenated Usa, LLC's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

Active since June 04, 2021

1935 COUNTY ROAD B2 W STE 74, ROSEVILLE, MN 55113(800) 583-5290 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Life Rejuvenated Usa, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE REJUVENATED USA, LLC (NPI 1780251223), doing business as Life Rejuvenated, is a healthcare organization registered as a point of service in Roseville, Minnesota and active in the NPI registry since June 2021. The organization lists Simon Mittal, President, as its authorized official.

NPPES Registry Identity

NPI1780251223

Entity TypeOrganization

Primary Taxonomy305S00000X

Legal Business NameLIFE REJUVENATED USA, LLC

Location Address1935 COUNTY ROAD B2 W STE 74Roseville, MN 55113-2722

Mailing Address1675 Village Trl E Unit 6Maplewood, MN 55109-5820 · (507) 363-9367

Phone(800) 583-5290

Organization SubpartNo

Authorized OfficialSimon MittalPresident · (507) 363-9367

Enumeration DateJune 4, 2021

NPPES CertifiedJune 4, 2021

✔ NPI 1780251223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPoint of ServiceManaged Care Organizations

Taxonomy Code305S00000X

Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

Also ListedRehabilitation PractitionerTaxonomy 225400000X

1935 COUNTY ROAD B2 W STE 74, Roseville, MN 55113

Open in Google Maps ↗

Other Names 1

Doing Business AsLife Rejuvenated

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Rejuvenated Usa, LLC's NPI number?

The NPI number for Life Rejuvenated Usa, LLC is 1780251223. It was assigned to this organization in the NPPES registry on June 4, 2021. The provider is doing business as Life Rejuvenated.

Where is Life Rejuvenated Usa, LLC located?

Life Rejuvenated Usa, LLC is located at 1935 County Road B2 W Ste 74, Roseville, MN 55113. The listed phone number is (800) 583-5290.

What is Life Rejuvenated Usa, LLC's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for Life Rejuvenated Usa, LLC was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.