Provider Demographics
NPI:1053891432
Name:THE INN SPOT COMMUNITY ACUPUNCTURE & STRESS RELIEF LOUNGE
Entity type:Organization
Organization Name:THE INN SPOT COMMUNITY ACUPUNCTURE & STRESS RELIEF LOUNGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-322-2713
Mailing Address - Street 1:1621 HOTEL CIR S # 128
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3323
Mailing Address - Country:US
Mailing Address - Phone:619-322-2713
Mailing Address - Fax:
Practice Address - Street 1:3505 CAMINO DEL RIO S STE 338
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4017
Practice Address - Country:US
Practice Address - Phone:619-550-5200
Practice Address - Fax:619-550-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X, 261QC1500X, 261QM0801X, 261QM1300X, 261QP3300X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility