Provider Demographics
NPI:1669061917
Name:THE BEAUTY OF WELLNESS, LLC
Entity type:Organization
Organization Name:THE BEAUTY OF WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-641-5890
Mailing Address - Street 1:PO BOX 15074
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-0074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3209 GUESS RD
Practice Address - Street 2:ST 204
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2692
Practice Address - Country:US
Practice Address - Phone:919-886-6033
Practice Address - Fax:919-981-9961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty