Provider Demographics
NPI:1619355922
Name:HEALING HANDS MASSAGES
Entity Type:Organization
Organization Name:HEALING HANDS MASSAGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAKEYSHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:AMONSMILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-714-0796
Mailing Address - Street 1:2581 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-4558
Mailing Address - Country:US
Mailing Address - Phone:757-714-0796
Mailing Address - Fax:
Practice Address - Street 1:2581 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504
Practice Address - Country:US
Practice Address - Phone:757-714-0796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019011604302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization