Provider Demographics
NPI:1700153251
Name:LIMA KAI MASSAGE INC
Entity Type:Organization
Organization Name:LIMA KAI MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DEYHLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:505-247-1469
Mailing Address - Street 1:200 3RD ST NW
Mailing Address - Street 2:SUITE #67
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3334
Mailing Address - Country:US
Mailing Address - Phone:505-247-1469
Mailing Address - Fax:
Practice Address - Street 1:200 3RD ST NW
Practice Address - Street 2:SUITE #67
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3334
Practice Address - Country:US
Practice Address - Phone:505-247-1469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6323225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty