Provider Demographics
NPI:1871825224
Name:MANIFESTO CORP
Entity Type:Organization
Organization Name:MANIFESTO CORP
Other - Org Name:LIFE HEALING THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:SABINO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZULLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-263-1955
Mailing Address - Street 1:156 N KALAHEO AVE APT D
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2345
Mailing Address - Country:US
Mailing Address - Phone:808-263-1955
Mailing Address - Fax:
Practice Address - Street 1:156 N KALAHEO AVE APT D
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2345
Practice Address - Country:US
Practice Address - Phone:808-263-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANIFESTO CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty