Provider Demographics
NPI:1841944667
Name:THE SPA AT YELLOW CREEK LLC
Entity type:Organization
Organization Name:THE SPA AT YELLOW CREEK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:VAZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-665-2555
Mailing Address - Street 1:3636 YELLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2269
Mailing Address - Country:US
Mailing Address - Phone:330-665-2555
Mailing Address - Fax:330-665-3838
Practice Address - Street 1:3636 YELLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2269
Practice Address - Country:US
Practice Address - Phone:330-665-2555
Practice Address - Fax:330-665-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty