Provider Demographics
NPI:1760589998
Name:LIFE REHAB SERVICES, INC.
Entity Type:Organization
Organization Name:LIFE REHAB SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-476-0224
Mailing Address - Street 1:600 TWELVE OAKS CENTER DR.
Mailing Address - Street 2:#638
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 TWELVE OAKS CENTER DR
Practice Address - Street 2:#638
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4501
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty