Provider Demographics
NPI:1952173957
Name:BEAUTY FROM BIRTH
Entity Type:Organization
Organization Name:BEAUTY FROM BIRTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-979-8474
Mailing Address - Street 1:12815 HAMILTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GOWEN
Mailing Address - State:MI
Mailing Address - Zip Code:49326-9447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12815 HAMILTON HILLS DR
Practice Address - Street 2:
Practice Address - City:GOWEN
Practice Address - State:MI
Practice Address - Zip Code:49326-9447
Practice Address - Country:US
Practice Address - Phone:616-535-9553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health