Provider Demographics
NPI:1881384097
Name:BEAUTY FOR ASHES CASE MANAGEMENT, LLC
Entity type:Organization
Organization Name:BEAUTY FOR ASHES CASE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ICWP CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:470-485-4423
Mailing Address - Street 1:833 HILLANDALE LN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-8843
Mailing Address - Country:US
Mailing Address - Phone:470-485-4423
Mailing Address - Fax:404-393-4766
Practice Address - Street 1:833 HILLANDALE LN
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-8843
Practice Address - Country:US
Practice Address - Phone:470-485-4423
Practice Address - Fax:404-393-4766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management