Provider Demographics
NPI:1164301271
Name:MAGNOLIA MASSAGE HAVEN AND ENERGY WORK LLC
Entity type:Organization
Organization Name:MAGNOLIA MASSAGE HAVEN AND ENERGY WORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MALYNN
Authorized Official - Last Name:RILEY- HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:443-901-8204
Mailing Address - Street 1:832 LOGAN LN
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7814
Mailing Address - Country:US
Mailing Address - Phone:443-901-8204
Mailing Address - Fax:
Practice Address - Street 1:1 CENTER SQ STE 1
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3013
Practice Address - Country:US
Practice Address - Phone:443-901-8204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty