Provider Demographics
NPI:1447595269
Name:ABILITY THERAPEUTIC SPA
Entity Type:Organization
Organization Name:ABILITY THERAPEUTIC SPA
Other - Org Name:ABILITY MASSAGE & DAY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BENCAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:225-982-8686
Mailing Address - Street 1:7656 JEFFERSON HWY
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1389
Mailing Address - Country:US
Mailing Address - Phone:225-928-8686
Mailing Address - Fax:225-928-8485
Practice Address - Street 1:7656 JEFFERSON HWY
Practice Address - Street 2:SUITE 1A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1389
Practice Address - Country:US
Practice Address - Phone:225-928-8686
Practice Address - Fax:225-928-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAE2407225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty