Provider Demographics
NPI:1811730005
Name:HEAVENLY HANDS MOBILE SPA LLC.
Entity type:Organization
Organization Name:HEAVENLY HANDS MOBILE SPA LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GADSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:908-349-0504
Mailing Address - Street 1:100 MORRIS AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1423
Mailing Address - Country:US
Mailing Address - Phone:908-349-0504
Mailing Address - Fax:908-349-0504
Practice Address - Street 1:100 MORRIS AVE STE 103B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1423
Practice Address - Country:US
Practice Address - Phone:908-349-0504
Practice Address - Fax:908-349-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty