Provider Demographics
NPI:1508617994
Name:RELIVAGAIN4LYF LLC
Entity Type:Organization
Organization Name:RELIVAGAIN4LYF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHNAUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:162-326-1566
Mailing Address - Street 1:8031 W BRIDEN LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1019
Mailing Address - Country:US
Mailing Address - Phone:623-261-5666
Mailing Address - Fax:
Practice Address - Street 1:10050 W BELL RD STE 29
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1290
Practice Address - Country:US
Practice Address - Phone:623-670-7985
Practice Address - Fax:602-297-6750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty