Provider Demographics
NPI:1477151108
Name:LIFEHOUSE MASSAGE & WELLNESS, LLC
Entity Type:Organization
Organization Name:LIFEHOUSE MASSAGE & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROWAN
Authorized Official - Middle Name:JAI
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:352-587-7807
Mailing Address - Street 1:8219 RIVER COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2137
Mailing Address - Country:US
Mailing Address - Phone:352-835-7410
Mailing Address - Fax:
Practice Address - Street 1:8219 RIVER COUNTRY DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34607-2137
Practice Address - Country:US
Practice Address - Phone:352-835-7410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center