Provider Demographics
NPI:1821265919
Name:QUE ATELIER SALON AND SPA, LLC
Entity Type:Organization
Organization Name:QUE ATELIER SALON AND SPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:302-740-0305
Mailing Address - Street 1:PO BOX 7026
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19714-7026
Mailing Address - Country:US
Mailing Address - Phone:302-740-0305
Mailing Address - Fax:
Practice Address - Street 1:3620 KIRKWOOD HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5104
Practice Address - Country:US
Practice Address - Phone:302-740-0305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0003432302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization