Provider Demographics
NPI:1740177013
Name:ROOT WARRIORZ HERBAL SPA LLC
Entity type:Organization
Organization Name:ROOT WARRIORZ HERBAL SPA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:JALEASE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-701-5181
Mailing Address - Street 1:511 N LINCOLN ST STE 444
Mailing Address - Street 2:
Mailing Address - City:HIGH SHOALS
Mailing Address - State:NC
Mailing Address - Zip Code:28077-9700
Mailing Address - Country:US
Mailing Address - Phone:704-601-2646
Mailing Address - Fax:
Practice Address - Street 1:121 W MAIN AVE STE 302
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4154
Practice Address - Country:US
Practice Address - Phone:704-601-5181
Practice Address - Fax:704-240-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-19
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty