Healthcare Provider Details

I. General information

NPI: 1003790841
Provider Name (Legal Business Name): RELIVAGAIN4LYF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 W THUNDERBIRD RD STE 120B
GLENDALE AZ
85306-4914
US

IV. Provider business mailing address

4920 W THUNDERBIRD RD STE 120B
GLENDALE AZ
85306-4914
US

V. Phone/Fax

Practice location:
  • Phone: 623-670-7985
  • Fax: 602-297-6750
Mailing address:
  • Phone: 623-670-7985
  • Fax: 602-297-6750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN M SCHNAUTZ
Title or Position: OWNER
Credential:
Phone: 623-670-7985