Provider Demographics
NPI:1689222309
Name:ZEN SPA HOSPITALITY LLC
Entity Type:Organization
Organization Name:ZEN SPA HOSPITALITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-722-8433
Mailing Address - Street 1:1054 AVE ASHFORD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1233
Mailing Address - Country:US
Mailing Address - Phone:787-722-8433
Mailing Address - Fax:
Practice Address - Street 1:1 CALLE SAN GERONIMO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901
Practice Address - Country:US
Practice Address - Phone:787-721-8433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PREM-113OtherHEALTH DEPARTMENT SARAFS LICENSE