Provider Demographics
NPI:1780461293
Name:THE SARA JANE WELLNESS BAR
Entity type:Organization
Organization Name:THE SARA JANE WELLNESS BAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:678-737-1822
Mailing Address - Street 1:401 WESTPARK CT STE 200
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3572
Mailing Address - Country:US
Mailing Address - Phone:678-737-1822
Mailing Address - Fax:
Practice Address - Street 1:401 WESTPARK CT STE 200
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3572
Practice Address - Country:US
Practice Address - Phone:678-737-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty