Provider Demographics
NPI:1033383880
Name:ADVANCED HAIR CENTERS
Entity Type:Organization
Organization Name:ADVANCED HAIR CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LECIEJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-0224
Mailing Address - Street 1:24800 CHAGRIN BLVD
Mailing Address - Street 2:STE 212
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5648
Mailing Address - Country:US
Mailing Address - Phone:216-292-0224
Mailing Address - Fax:
Practice Address - Street 1:24800 CHAGRIN BLVD
Practice Address - Street 2:STE 212
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5648
Practice Address - Country:US
Practice Address - Phone:216-292-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier