Provider Demographics
NPI:1578271896
Name:HAIR & BEAUTY TREATMENT CENTER
Entity Type:Organization
Organization Name:HAIR & BEAUTY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRIN-SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:706-373-9184
Mailing Address - Street 1:524 SHARTOM DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4751
Mailing Address - Country:US
Mailing Address - Phone:706-373-9184
Mailing Address - Fax:
Practice Address - Street 1:524 SHARTOM DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-4751
Practice Address - Country:US
Practice Address - Phone:706-373-9184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty