Provider Demographics
NPI:1518272491
Name:CREATEDHAIR DESIGNS, LLC
Entity Type:Organization
Organization Name:CREATEDHAIR DESIGNS, LLC
Other - Org Name:CREATEDHAIR.COM AND SALONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-550-0721
Mailing Address - Street 1:10390 WILSHIRE BLVD. SUITE 1209
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6454
Mailing Address - Country:US
Mailing Address - Phone:310-550-0721
Mailing Address - Fax:310-278-9070
Practice Address - Street 1:10390 WILSHIRE BLVD. SUITE 1209
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:310-550-0721
Practice Address - Fax:310-278-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies