Provider Demographics
NPI:1205510054
Name:SAP AND SOUL DAY SPA LLC
Entity type:Organization
Organization Name:SAP AND SOUL DAY SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHNTAE
Authorized Official - Middle Name:LANA
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:910-859-0667
Mailing Address - Street 1:5129 CHASTEAL TRL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6421
Mailing Address - Country:US
Mailing Address - Phone:919-616-9252
Mailing Address - Fax:
Practice Address - Street 1:920 PAVERSTONE DR STE B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4723
Practice Address - Country:US
Practice Address - Phone:919-228-8501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty