Organization
AL&G ENTERPRIZE
Active
Parent organization
BELLA BEAUTY HAIR SALON
Other names
Bella Beauty Hair Restoration Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BELLA BEAUTY HAIR SALON
Authorized official
AMBER LYNN GRAHAM (CERTIFIED HAIR LOSS SPECIALLST)
(870) 390-1501
Entity
Organization
Contact information
Practice address
2243 MOUNT HOLLY RD, CAMDEN, AR 71701-6226
(870) 390-1501
Mailing address
2243 MOUNT HOLLY RD, CAMDEN, AR 71701-6226
(870) 390-1501
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1744P3200X
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744P3200X
CERTIFIED HAIR LOSS SPECIALIST
AR
Enumeration date
08/20/2015
Last updated
08/20/2015
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