MEDICARE: EXALTED BEAUTY INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	253Z00000X	In Home Supportive Care Agency
3	385HR2055X	Child Mental Illness Respite Care
4	385H00000X	Respite Care
5	332B00000X	Durable Medical Equipment & Medical Supplies
6	261QS1000X	Student Health Clinic/Center
7	251J00000X	Nursing Care Agency
8	315P00000X	Intellectual Disabilities Intermediate Care Facility
9	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
10	310400000X	Assisted Living Facility
11	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
12	3747P1801X	Personal Care Attendant
13	385HR2065X	Child Physical Disabilities Respite Care
14	251C00000X	Developmentally Disabled Services Day Training Agency
15	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1770442162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXALTED BEAUTY INC.

Provider Business Mailing Address
First Line	:	6425 TULIP ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3324
Country	:	US
Telephone Number	:	267-298-6373
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 TULIP ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3324
Country	:	US
Telephone Number	:	267-298-6373
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. SAMIYYAH JORDAN
Credential	:
Telephone Number	:	267-298-6373

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/26/2026

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Directions to “EXALTED BEAUTY INC. ” Practice Location

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