Real Custom Hair

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CO094395 Issued in GA

Legal business name

REAL CUSTOM HAIR

Practice address

2451 Cumberland Pkwy SE
300-3711
Atlanta, GA 30339-6136

Phone

(678) 733-6466

NPI assigned

Jul 25, 2016

Organization subpart

No

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

Authorized official

Name

Nikki Bell

Title

Ceo

Phone

(678) 733-6466

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1780137844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 CUMBERLAND PKWY SE",
            "address_2": "300-3711",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396136",
            "telephone_number": "678-733-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 CUMBERLAND PKWY SE",
            "address_2": "300-3711",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396136",
            "telephone_number": "678-733-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL CUSTOM HAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-733-6466"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "CO094395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Meghan Ready, LMFT
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• Mirrin E Reagan, RN, NP
• Real Wellness Enterprises LLC
• Donna Endsley Real, LCSW
• Joya Janai Reasor
• Graham Reaves, MSOT
• Jennifer Hood Reaves

• Prosthetic/Orthotic Supplier in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.