Provider Demographics
NPI:1396187423
Name:MASSAGE HEALTH & HEALING ENERGIES, LLC
Entity Type:Organization
Organization Name:MASSAGE HEALTH & HEALING ENERGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEANGELIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:401-429-6113
Mailing Address - Street 1:PO BOX 6659
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-6659
Mailing Address - Country:US
Mailing Address - Phone:401-437-1652
Mailing Address - Fax:401-427-0827
Practice Address - Street 1:310 MAPLE AVE
Practice Address - Street 2:SUITE L 05-B
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3430
Practice Address - Country:US
Practice Address - Phone:401-437-1652
Practice Address - Fax:401-427-0827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT01948225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty