Provider Demographics
NPI:1922689595
Name:HEAVENLY HANDS HOLISTIC OASIS
Entity Type:Organization
Organization Name:HEAVENLY HANDS HOLISTIC OASIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHAUNA
Authorized Official - Middle Name:DONISE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:313-995-2374
Mailing Address - Street 1:6727 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3767
Mailing Address - Country:US
Mailing Address - Phone:131-399-5237
Mailing Address - Fax:313-436-5195
Practice Address - Street 1:6727 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3767
Practice Address - Country:US
Practice Address - Phone:313-995-2374
Practice Address - Fax:313-436-5195
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALON HEAVENLY HANDS/HEAVENLY HANDS MASSAGE & ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty