Provider Demographics
NPI:1598505562
Name:ADARA BEAUTY AND WELLNESS
Entity type:Organization
Organization Name:ADARA BEAUTY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-629-0848
Mailing Address - Street 1:31500 W 13 MILE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2172
Mailing Address - Country:US
Mailing Address - Phone:248-629-0848
Mailing Address - Fax:
Practice Address - Street 1:31500 W 13 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2172
Practice Address - Country:US
Practice Address - Phone:248-629-0848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service