Provider Demographics
NPI:1083067615
Name:LA' CHE HAIR EXTENSIONS
Entity Type:Organization
Organization Name:LA' CHE HAIR EXTENSIONS
Other - Org Name:LA' CHE STYLES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYEISHA
Authorized Official - Middle Name:LACHELE
Authorized Official - Last Name:HEIDELBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-318-9915
Mailing Address - Street 1:123 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7622
Mailing Address - Country:US
Mailing Address - Phone:614-318-9915
Mailing Address - Fax:
Practice Address - Street 1:123 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7622
Practice Address - Country:US
Practice Address - Phone:614-318-9915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies