Provider Demographics
NPI:1558141382
Name:BEAUTYFUL CREATIONS LLC.
Entity Type:Organization
Organization Name:BEAUTYFUL CREATIONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-519-7826
Mailing Address - Street 1:2621 W PIERCE ST APT 317
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-1084
Mailing Address - Country:US
Mailing Address - Phone:414-519-7826
Mailing Address - Fax:
Practice Address - Street 1:2621 W PIERCE ST APT 317
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-1084
Practice Address - Country:US
Practice Address - Phone:414-519-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management