Healthcare Provider Details

I. General information

NPI: 1265838288
Provider Name (Legal Business Name): A HEALING TOUCH WITH A WARM SPIRIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 COZY COR
AVENEL NJ
07001-1123
US

IV. Provider business mailing address

PO BOX 337
AVENEL NJ
07001-0337
US

V. Phone/Fax

Practice location:
  • Phone: 732-688-3303
  • Fax:
Mailing address:
  • Phone: 732-688-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT00167200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEISHA HOWELL
Title or Position: OWNER LICENSE MASSAGE THERAPIST
Credential:
Phone: 732-688-3303