Organization · NPI-2

Beauticians On The Go, PLLC

Home Health · Phoenix, AZ

NPI number1972015105
StatusActive
Last updated in NPPESApr 18, 2018

Details

NPI
1972015105
Entity type
Organization (NPI-2)
Legal business name
Beauticians On The Go, PLLC
Organization subpart
No
Enumeration date
Oct 27, 2017
Last updated
Apr 18, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health10223435AZYes
305S00000X Point of Service10223435AZ
253Z00000X In Home Supportive Care10223435AZ

Practice location

2390 E Camelback Rd Ste 130
Phoenix, AZ 85016-3449

Phone 602-803-2827 · Fax 602-218-4498

Mailing address

Po Box 74322
New River, AZ 85087-1006

Phone 602-803-2728 · Fax 602-218-4498

Authorized official

Carla R Olivares
Ceo
6028032827

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