Provider Demographics
NPI:1194216309
Name:TRANQUILITY MASSAGE & SPA LLC
Entity Type:Organization
Organization Name:TRANQUILITY MASSAGE & SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-353-6086
Mailing Address - Street 1:1603 BOONE ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-5270
Mailing Address - Country:US
Mailing Address - Phone:337-353-6086
Mailing Address - Fax:337-397-4622
Practice Address - Street 1:1603 BOONE ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-5270
Practice Address - Country:US
Practice Address - Phone:337-353-6086
Practice Address - Fax:337-397-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty