MEDICARE: EDEN DAY SPA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1811746167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDEN DAY SPA LLC

Provider Business Mailing Address
First Line	:	111 BRAMBER DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-7701
Country	:	US
Telephone Number	:	337-257-3299
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 RUE LOUIS XIV STE A
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5766
Country	:	US
Telephone Number	:	337-295-3330
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MASSAGE THERAPIST
Name	:	MS. KAREN MICHELLE CASTRO
Credential	:	LMT
Telephone Number	:	337-257-3299

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	04/22/2025

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