Provider Demographics
NPI:1831442540
Name:INVIGORATE REHAB INC
Entity type:Organization
Organization Name:INVIGORATE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:517-410-7880
Mailing Address - Street 1:1722 OLIVE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1700
Mailing Address - Country:US
Mailing Address - Phone:517-410-7880
Mailing Address - Fax:
Practice Address - Street 1:1722 OLIVE ST STE 201
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1700
Practice Address - Country:US
Practice Address - Phone:517-410-7880
Practice Address - Fax:314-261-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018807261QR0400X
MO2012012469261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation