MEDICARE: HAIR'UM IN MOTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	233238	FL
2	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306244488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAIR'UM IN MOTION

Provider Business Mailing Address
First Line	:	3794 VICTORIA RD
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33411-6440
Country	:	US
Telephone Number	:	561-629-5067
Fax Number	:

Provider Business Practice Location Address
First Line	:	3794 VICTORIA RD
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33411-6440
Country	:	US
Telephone Number	:	561-629-5067
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KIMBERLY BLACK
Credential	:
Telephone Number	:	561-629-5067

Provider Enumeration Date	:	12/05/2014
Last Update Date	:	04/12/2021

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Directions to “HAIR'UM IN MOTION ” Practice Location

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