Organization
BEAUTIFLI, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN TERRELL BAINES P.H. D (CIO)
(682) 304-1887
Entity
Organization
Contact information
Practice address
1745 GEORGE WASHINGTON CARVER AVE, SHREVEPORT, LA 71107-6112
(682) 760-5530
Mailing address
1745 GEORGE WASHINGTON CARVER AVE, SHREVEPORT, LA 71107-6112
(682) 760-5530
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008082718
—
LA
Enumeration date
08/12/2022
Last updated
09/11/2025
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