Provider Demographics
NPI:1972353878
Name:THE HAIR 4ORCE SALON
Entity Type:Organization
Organization Name:THE HAIR 4ORCE SALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLYFVELDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-280-1922
Mailing Address - Street 1:15 VALLEY ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2809
Mailing Address - Country:US
Mailing Address - Phone:973-280-1922
Mailing Address - Fax:
Practice Address - Street 1:15 VALLEY ST STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2809
Practice Address - Country:US
Practice Address - Phone:973-280-1922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment