Provider Demographics
NPI:1487450771
Name:AMANI: A CLEANSING PLACE, LLC
Entity type:Organization
Organization Name:AMANI: A CLEANSING PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRYSTAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:901-240-8867
Mailing Address - Street 1:1135 TANGLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38114-6719
Mailing Address - Country:US
Mailing Address - Phone:901-621-6712
Mailing Address - Fax:
Practice Address - Street 1:306 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-4206
Practice Address - Country:US
Practice Address - Phone:901-621-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty