Provider Demographics
NPI:1477020519
Name:BHAKTI MASSAGE & SPA SERVICES LLC
Entity Type:Organization
Organization Name:BHAKTI MASSAGE & SPA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BHAKTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PENAROZA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-352-3335
Mailing Address - Street 1:2700 S KING ST # 11104
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3349
Mailing Address - Country:US
Mailing Address - Phone:808-352-3335
Mailing Address - Fax:
Practice Address - Street 1:401 KAMAKEE ST STE 404
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4261
Practice Address - Country:US
Practice Address - Phone:808-352-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty