Provider Demographics
NPI:1093350886
Name:CONTINENTAL SPA LLC
Entity Type:Organization
Organization Name:CONTINENTAL SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-906-8358
Mailing Address - Street 1:210 W CONTINENTAL RD STE 130A
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-3546
Mailing Address - Country:US
Mailing Address - Phone:520-906-8358
Mailing Address - Fax:
Practice Address - Street 1:210 W CONTINENTAL RD STE 130A
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-3546
Practice Address - Country:US
Practice Address - Phone:520-906-8358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty