Provider Demographics
NPI:1326477241
Name:WELLNESS SPA AND CLINIC INC
Entity Type:Organization
Organization Name:WELLNESS SPA AND CLINIC INC
Other - Org Name:HEALING TOUCH WELLNESS SPA AND CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-202-0046
Mailing Address - Street 1:7673 WINNETKA AVE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2677
Mailing Address - Country:US
Mailing Address - Phone:747-202-0046
Mailing Address - Fax:747-202-0048
Practice Address - Street 1:7673 WINNETKA AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-2677
Practice Address - Country:US
Practice Address - Phone:747-202-0046
Practice Address - Fax:747-202-0048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS SPA AND CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-01
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization