NPIMap

Organization Active NPI

Grace & Beauty Hair Restoration and Treatment Center, LLC

  • Prosthetics Case Management
  • Forest Park, GA
National Provider Identifier
1629443387
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
CO084847 Issued in GA
Legal business name
GRACE & BEAUTY HAIR RESTORATION AND TREATMENT CENTER, LLC
Practice address
5891 Ash St
Suite B
Forest Park, GA 30297-3016
Phone
(404) 366-4429
NPI assigned
Dec 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Authorized official

Name
Ms. Jeleva Carr
Title
Owner/Manager
Phone
(404) 366-4429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X CO084847 GA Primary

Addresses

Primary practice location

5891 Ash St
Suite B
Forest Park, GA 30297-3016

Mailing address

5891 Ash St
Suite B
Forest Park, GA 30297-3016

National Provider Directory

National Provider Directory

Locations

5891 Ash St
#B
Forest Park, GA 30297
Phone (404) 366-4429

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1629443387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5891 ASH ST",
            "address_2": "SUITE B",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5891 ASH ST",
            "address_2": "SUITE B",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973016",
            "telephone_number": "404-366-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE & BEAUTY HAIR RESTORATION AND TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "JELEVA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "404-366-4429",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": "CO084847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.