MEDICARE: FLAWSME BY LUCY EUSTACIA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	251J00000X	Nursing Care Agency
4	251K00000X	Public Health or Welfare Agency
5	251S00000X	Community/Behavioral Health Agency
6	252Y00000X	Early Intervention Provider Agency
7	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
8	261QM2800X	Methadone Clinic
9	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
10	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
11	320800000X	Mental Illness Community Based Residential Treatment Facility
12	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
13	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1467199182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAWSME BY LUCY EUSTACIA

Provider Business Mailing Address
First Line	:	4637 COLERIDGE CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-5117
Country	:	US
Telephone Number	:	740-974-2963
Fax Number	:

Provider Business Practice Location Address
First Line	:	4637 COLERIDGE CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-5117
Country	:	US
Telephone Number	:	740-974-2963
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	LUCY GALES
Credential	:	LPN
Telephone Number	:	740-974-2963

Provider Enumeration Date	:	05/14/2022
Last Update Date	:	05/14/2022

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