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Organization

BEAUTICIANS ON THE GO, PLLC

Active
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Organization

BEAUTICIANS ON THE GO, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLA R OLIVARES COSMETOLOGIST (CEO)
(602) 803-2827
Entity
Organization

Contact information

Practice address
2390 E CAMELBACK RD STE 130, PHOENIX, AZ 85016-3449
(602) 803-2827
(602) 218-4498
Mailing address
PO BOX 74322, NEW RIVER, AZ 85087-1006
(602) 803-2728
(602) 218-4498

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
10223435
AZ
253Z00000X
In Home Supportive Care Agency
10223435
AZ
305S00000X
Point of Service
10223435
AZ

Other

Enumeration date
10/27/2017
Last updated
04/18/2018
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