Organization
FLAWLESS SKIN IV HYDRATION MED SPA
Active
Organization
FLAWLESS SKIN IV HYDRATION MED SPA
Active
Other names
Flawless Skin IV Hydration Med Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDITH ELLIS DNP,MSN,CNL,RN (FOUNDER/CEO)
(323) 538-1110
Entity
Organization
Contact information
Practice address
25101 THE OLD RD, STEVENSON RANCH, CA 91381-2206
(323) 538-1110
Mailing address
25101 THE OLD RD, STEVENSON RANCH, CA 91381-2206
(323) 538-1110
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251T00000X
PACE Provider Organization
—
—
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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