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General NPI Number Information
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NPI Number | 1770497190
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Entity Type | Organization
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Legal Business Name | THE HANDS OF EDEN LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | CLIENTS PLACE
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City | PORTLAND
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State | ME
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Zip | 04101
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Country | US
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Telephone | 207-747-8944
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Fax |
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Provider Business Mailing Address
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Address Line | CUMBERLAND AVE (MOBILE MASSAGE ONLY)
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City | PORTLAND
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State | ME
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Zip | 04101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JAVERE R SHAW
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Credential | LMT
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Telephone | 207-747-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | NULL
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