MEDICARE: REJUVENATING CONCEPTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	8906	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326264391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REJUVENATING CONCEPTS

Provider Business Mailing Address
First Line	:	3920 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4859
Country	:	US
Telephone Number	:	504-942-7171
Fax Number	:	504-942-7174

Provider Business Practice Location Address
First Line	:	3920 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4859
Country	:	US
Telephone Number	:	504-942-7171
Fax Number	:	504-942-7174

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. DELISA TATE
Credential	:
Telephone Number	:	504-942-7171

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/22/2020

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Directions to “REJUVENATING CONCEPTS ” Practice Location

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