Provider Demographics
NPI:1760247563
Name:LUXURY HEALING HOUSE LLC
Entity Type:Organization
Organization Name:LUXURY HEALING HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANTANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:470-260-4623
Mailing Address - Street 1:2274 SALEM RD SE STE 1061720
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2097
Mailing Address - Country:US
Mailing Address - Phone:470-260-4623
Mailing Address - Fax:
Practice Address - Street 1:2274 SALEM RD SE STE 1061720
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2097
Practice Address - Country:US
Practice Address - Phone:470-260-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care