Provider Demographics
NPI:1518534411
Name:A BEAUTIFUL EXPERIENCE LLC
Entity Type:Organization
Organization Name:A BEAUTIFUL EXPERIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RASHEEDA
Authorized Official - Middle Name:JAMEELAH
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN, CHES, DOULA
Authorized Official - Phone:443-854-9341
Mailing Address - Street 1:1654 NORTHGATE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-1650
Mailing Address - Country:US
Mailing Address - Phone:443-854-9341
Mailing Address - Fax:
Practice Address - Street 1:1654 NORTHGATE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-1650
Practice Address - Country:US
Practice Address - Phone:443-854-9341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal DialysisGroup - Multi-Specialty