Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Life Rejuvenated USA, LLC

Organization Rehabilitation Practitioner · NPI 1780251223

Life Rejuvenated USA, LLC is a Rehabilitation Practitioner in Roseville, Minnesota. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1935 County Road B2 W Ste 74
Roseville, MN 55113-2722
Phone: (800) 583-5290
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Point of Service (primary) Taxonomy 305S00000X
Rehabilitation Practitioner Taxonomy 225400000X

Record details

NPI number1780251223
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Simon Mittal — President · (507) 363-9367
Other names Life Rejuvenated
NPI enumeratedJune 4, 2021
Last updated in NPPESJune 4, 2021
Certification dateJune 4, 2021
Mailing address1675 Village Trl E Unit 6, Maplewood, MN 55109-5820

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