Provider Demographics
NPI:1548982929
Name:HEALING HANDS FOR THE SOUL MASSAGE INC
Entity type:Organization
Organization Name:HEALING HANDS FOR THE SOUL MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:AKEYA
Authorized Official - Last Name:HAACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-541-4683
Mailing Address - Street 1:2112 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6475
Mailing Address - Country:US
Mailing Address - Phone:208-541-4683
Mailing Address - Fax:
Practice Address - Street 1:2112 E 25TH ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6475
Practice Address - Country:US
Practice Address - Phone:208-541-4683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty