| Rejuvenate Health | |
|
1935 Lutcher Ave Lutcher LA 70071-7076 | |
| (225) 806-1168 | |
| Not Available |
| Full Name | Rejuvenate Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1935 Lutcher Ave, Lutcher, Louisiana |
| Authorized Official Name and Position | Hailey Entremont (FNP-C/OWNER) |
| Authorized Official Contact | 2258061168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rejuvenate Health 2667 Bellevue Lakes Dr Paulina LA 70763-2383 Ph: (225) 806-1168 | Rejuvenate Health 1935 Lutcher Ave Lutcher LA 70071-7076 Ph: (225) 806-1168 |
| NPI Number | 1063129963 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 9638544034 |
|---|---|
| Medicare Enrollment ID | O20230418001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063129963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Hailey R Entremont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104120138 PECOS PAC ID: 6103005863 Enrollment ID: I20110126001040 |
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