Provider Demographics
NPI:1467226019
Name:LUXE LAIRS LLC
Entity Type:Organization
Organization Name:LUXE LAIRS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITANY
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-207-1285
Mailing Address - Street 1:1898 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5090
Mailing Address - Country:US
Mailing Address - Phone:559-207-1285
Mailing Address - Fax:
Practice Address - Street 1:1898 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-5090
Practice Address - Country:US
Practice Address - Phone:559-207-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle