Provider Demographics
NPI:1790173284
Name:SALONS BY JB INC
Entity Type:Organization
Organization Name:SALONS BY JB INC
Other - Org Name:SALONS BY JB INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENINCOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-243-8679
Mailing Address - Street 1:5580 GOODS LN STE 401
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2839
Mailing Address - Country:US
Mailing Address - Phone:814-996-4309
Mailing Address - Fax:
Practice Address - Street 1:5580 GOODS LN STE 401
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2839
Practice Address - Country:US
Practice Address - Phone:814-996-4309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty