Provider Demographics
NPI:1710455530
Name:ESCAPE AWAY MASSAGE
Entity type:Organization
Organization Name:ESCAPE AWAY MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-941-1895
Mailing Address - Street 1:587 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NEW YORK MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:13417-1489
Mailing Address - Country:US
Mailing Address - Phone:315-768-1155
Mailing Address - Fax:
Practice Address - Street 1:587 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:NEW YORK MILLS
Practice Address - State:NY
Practice Address - Zip Code:13417-1489
Practice Address - Country:US
Practice Address - Phone:315-768-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARBONE ATHLETICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty