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General NPI Number Information
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NPI Number | 1114710993
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Entity Type | Organization
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Legal Business Name | SPA PHOENIX, LLC
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 13921 YUKON AVE APT 253
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City | HAWTHORNE
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State | CA
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Zip | 90250-8130
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Country | US
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Telephone | 877-756-2258
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Fax |
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Provider Business Mailing Address
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Address Line | 13921 YUKON AVE APT 253
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City | HAWTHORNE
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State | CA
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Zip | 90250-8130
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Country | US
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Telephone | 877-756-2258
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER/DOULA
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Name | RO'SHAWNA RASHADA
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Credential |
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Telephone | 877-756-2258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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