Provider Demographics
NPI:1568193076
Name:REJUVENATING HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:REJUVENATING HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-288-7625
Mailing Address - Street 1:2361 S FLANDERS ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-9456
Mailing Address - Country:US
Mailing Address - Phone:720-288-7625
Mailing Address - Fax:
Practice Address - Street 1:13731 E RICE PL STE 101
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1063
Practice Address - Country:US
Practice Address - Phone:720-288-7625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty