Healthcare Provider Details

I. General information

NPI: 1740111806
Provider Name (Legal Business Name): KEY LUXURY SPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 1/2 MONTANA AVE STE A
SANTA MONICA CA
90403-1807
US

IV. Provider business mailing address

2934 1/2 N BEVERLY GLEN CIR # 448
LOS ANGELES CA
90077-1745
US

V. Phone/Fax

Practice location:
  • Phone: 310-770-8233
  • Fax:
Mailing address:
  • Phone: 310-770-8276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHELE MOORE
Title or Position: CEO
Credential:
Phone: 310-770-8276