1033899232 NPI number — ADVANCED HAIR SOLUTIONS OF BLOOMFIELD HILLS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033899232 NPI number — ADVANCED HAIR SOLUTIONS OF BLOOMFIELD HILLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED HAIR SOLUTIONS OF BLOOMFIELD HILLS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033899232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33332 TWELVE MILE RD
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-242-4756
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33332 TWELVE MILE RD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
FARMINGTON HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-242-4756
Provider Business Practice Location Address Fax Number:
877-940-2756
Provider Enumeration Date:
07/21/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HUDDLESTON
Authorized Official First Name:
LAMIRIA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CEO/FOUNDER
Authorized Official Telephone Number:
877-242-4756

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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