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General NPI Number Information
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NPI Number | 1750886289
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL AFFECTATION
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 1415 ARVILLE ST STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89102-0536
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Country | US
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Telephone | 702-626-7637
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 ARVILLE ST STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89102-0536
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Country | US
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Telephone | 702-353-6738
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PATRICE BINGHAM
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Credential |
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Telephone | 702-626-7637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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