Provider Demographics
NPI:1902101025
Name:RAINDANCE HEALING CENTERS
Entity Type:Organization
Organization Name:RAINDANCE HEALING CENTERS
Other - Org Name:PERFORMANCE SPORTS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:STAPLETON HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, MMP, MAT
Authorized Official - Phone:520-551-3497
Mailing Address - Street 1:310 N WILMOT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2618
Mailing Address - Country:US
Mailing Address - Phone:520-551-3497
Mailing Address - Fax:
Practice Address - Street 1:310 N WILMOT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2618
Practice Address - Country:US
Practice Address - Phone:520-551-3497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty