Organization
THE KOKO BELLA PERMANENT MAKEUP AND LASH BAR
Active
Other names
Koko Bella Diamonds
Organization subpart
No
Provider details
NPI number
Authorized official
CARNEKA J GREEN (CERTIFIED PEER RECOVERY SUPPORTER)
(330) 371-6698
Entity
Organization
Contact information
Practice address
1911 BALTIMORE REYNOLDSBURG RD, REYNOLDSBURG, OH 43068-8105
(614) 452-9821
Mailing address
257 KINGSMEADOW LN, BLACKLICK, OH 43004-9204
(330) 371-6698
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
374J00000X
Doula
—
—
Other
Enumeration date
06/12/2025
Last updated
08/11/2025
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