Restored Crown Hair Restoration Clinic LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

RESTORED CROWN HAIR RESTORATION CLINIC LLC

Practice address

3766 US Highway 17 Ste 102
Richmond Hill, GA 31324-8872

Phone

(912) 312-7272

NPI assigned

Feb 3, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Takara Harris, TRICHOLOGISTNPI 1598225534

Title

Owner

Phone

(443) 686-2487

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Takara N Harris, TRICHOLOGIST

  • Customized Equipment (DME)
  • Richmond Hill, GA
  • NPI 1598225534

  Specialist

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1407447261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3766 US HIGHWAY 17 STE 102",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248872",
            "telephone_number": "912-312-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3766 US HIGHWAY 17 STE 102",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248872",
            "telephone_number": "912-312-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORED CROWN HAIR RESTORATION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TAKARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-686-2487",
        "authorized_official_credential": "TRICHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tori Nikale Randall
• Tazjae Reid
• Renee Elizabeth Renfroe-Myers
• Juanita Marianena Reno, LCSW
• Resilience Physical Therapy & Wellness LLC
• Alondra Reyna Lopez
• Crystal Nicole Reynolds, MS, OTR/L
• Brenda Sue Richardson, PH.D.
• Robert Anthony Richardson, PSY.D.
• Tillarah Richardson, RBT

• Customized Equipment (DME) in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.