Organization
BEAUTIFUL GRACE, LLC
Active
Other names
Beautiful Grace Unique Creations
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTEAU SYLVESTER (CRANIAL PROSTHESIS SPECIALIST)
(318) 239-1312
Entity
Organization
Contact information
Practice address
100 HANDY HILL RD, MER ROUGE, LA 71261-6900
(318) 239-1312
Mailing address
100 HANDY HILL RD, MER ROUGE, LA 71261-6900
(318) 239-1312
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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