Active NPI
Hair Revolution LLC
- Clinic/Center
- Lathrup Village, MI
National Provider Identifier
1073480133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- HAIR REVOLUTION LLC
- Practice address
- 17535 Coral Gables Ave
Lathrup Village, MI 48076-4603 - Phone
- (248) 259-2757
- NPI assigned
- Oct 22, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Saundranita Rezia Powe, TRICHOLOGIST
- Title
- Owner/Trichologist
- Phone
- (248) 259-2757
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
17535 Coral Gables Ave
Lathrup Village, MI 48076-4603
Mailing address
17535 Coral Gables Ave
Lathrup Village, MI 48076-4603
Phone (248) 259-2757
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Prosthetics Case Management
- West Bloomfield, MI
- NPI 1619586682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761091200000",
"number": "1073480133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17535 CORAL GABLES AVE",
"city": "LATHRUP VILLAGE",
"state": "MI",
"postal_code": "480764603",
"telephone_number": "248-259-2757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17535 CORAL GABLES AVE",
"city": "LATHRUP VILLAGE",
"state": "MI",
"postal_code": "480764603",
"telephone_number": "248-259-2757"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAIR REVOLUTION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-22",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A",
"authorized_official_last_name": "POWE",
"authorized_official_first_name": "SAUNDRANITA",
"authorized_official_middle_name": "REZIA",
"authorized_official_title_or_position": "OWNER/TRICHOLOGIST",
"authorized_official_telephone_number": "248-259-2757",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "TRICHOLOGIST"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lathrup Village, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.