Provider Demographics
NPI:1366853517
Name:SIMON ADVENTURES, LLC
Entity Type:Organization
Organization Name:SIMON ADVENTURES, LLC
Other - Org Name:MASSAGE HEIGHTS - WESTPARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-920-5777
Mailing Address - Street 1:3881 ALTON PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8224
Mailing Address - Country:US
Mailing Address - Phone:949-383-5388
Mailing Address - Fax:949-783-0891
Practice Address - Street 1:19401 SAINT JUDE DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-1342
Practice Address - Country:US
Practice Address - Phone:714-669-1470
Practice Address - Fax:714-669-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty