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General NPI Number Information
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NPI Number | 1841092418
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Entity Type | Organization
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Legal Business Name | THE HAVEN AT CARY MASSAGE, LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 150 IOWA LN STE 110
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City | CARY
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State | NC
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Zip | 27511-4496
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Country | US
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Telephone | 919-374-8013
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Fax |
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Provider Business Mailing Address
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Address Line | 112 HUNTERS GLEN CT
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City | MORRISVILLE
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State | NC
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Zip | 27560-7309
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Country | US
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Telephone | 919-374-8013
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA JOHNSON
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Credential | LMBT
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Telephone | 919-374-8013
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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 |
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