Provider Demographics
NPI:1215470323
Name:WATER LILY FLOAT SPA, LLC
Entity type:Organization
Organization Name:WATER LILY FLOAT SPA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILY
Authorized Official - Middle Name:LEUNG
Authorized Official - Last Name:CAUSIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:808-683-6007
Mailing Address - Street 1:320 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4001
Mailing Address - Country:US
Mailing Address - Phone:808-675-8399
Mailing Address - Fax:
Practice Address - Street 1:320 WARD AVENUE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-675-8399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty