Provider Demographics
NPI:1093382434
Name:REJUVE LLC
Entity Type:Organization
Organization Name:REJUVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-608-7528
Mailing Address - Street 1:2714 W LAKE HOUSTON PKWY STE 180
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5233
Mailing Address - Country:US
Mailing Address - Phone:281-608-7528
Mailing Address - Fax:
Practice Address - Street 1:2714 W LAKE HOUSTON PKWY STE 180
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5233
Practice Address - Country:US
Practice Address - Phone:281-608-7528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain