Provider Demographics
NPI:1093859555
Name:ACADEMY OF HEALING ARTS, INC
Entity Type:Organization
Organization Name:ACADEMY OF HEALING ARTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:772-562-8905
Mailing Address - Street 1:1408 19TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3527
Mailing Address - Country:US
Mailing Address - Phone:772-562-8905
Mailing Address - Fax:772-562-7071
Practice Address - Street 1:1408 19TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3527
Practice Address - Country:US
Practice Address - Phone:772-562-8905
Practice Address - Fax:772-562-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2010-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA8395225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty