Provider Demographics
NPI:1295005148
Name:WHITE CRANE HEALING ARTS CENTER, INC.
Entity Type:Organization
Organization Name:WHITE CRANE HEALING ARTS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:IBORRA
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:954-721-7252
Mailing Address - Street 1:7071 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2143
Mailing Address - Country:US
Mailing Address - Phone:954-721-7252
Mailing Address - Fax:
Practice Address - Street 1:7071 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 2C
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2143
Practice Address - Country:US
Practice Address - Phone:954-721-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP460171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty