Provider Demographics
NPI:1275399453
Name:LABOUR OF LOVE HEALING HANDS LLC
Entity Type:Organization
Organization Name:LABOUR OF LOVE HEALING HANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL MASSAGE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:219-902-0352
Mailing Address - Street 1:1357 GERRY ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46406-2166
Mailing Address - Country:US
Mailing Address - Phone:219-902-0352
Mailing Address - Fax:
Practice Address - Street 1:1357 GERRY ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46406-2166
Practice Address - Country:US
Practice Address - Phone:219-902-0352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty