Provider Demographics
NPI:1912612185
Name:ADVANCED MIND & BODY SPA, INC
Entity Type:Organization
Organization Name:ADVANCED MIND & BODY SPA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:808-485-1070
Mailing Address - Street 1:99-115 AIEA HEIGHTS DR STE 277
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3975
Mailing Address - Country:US
Mailing Address - Phone:808-485-1070
Mailing Address - Fax:808-488-9301
Practice Address - Street 1:99-115 AIEA HEIGHTS DR STE 277
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3975
Practice Address - Country:US
Practice Address - Phone:808-485-1070
Practice Address - Fax:808-488-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty