Provider Demographics
NPI:1598133555
Name:IN ESSENCE DAY SPA, LLC
Entity Type:Organization
Organization Name:IN ESSENCE DAY SPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LILIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACCHARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:949-322-7981
Mailing Address - Street 1:23162 LOS ALISOS BLVD STE 102B
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-7861
Mailing Address - Country:US
Mailing Address - Phone:949-322-7981
Mailing Address - Fax:
Practice Address - Street 1:23162 LOS ALISOS BLVD STE 102B
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7861
Practice Address - Country:US
Practice Address - Phone:949-322-7981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4443225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty