Provider Demographics
NPI:1578399267
Name:DISTRICT 127 HAIR ATELIER
Entity type:Organization
Organization Name:DISTRICT 127 HAIR ATELIER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANEECE
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-522-6121
Mailing Address - Street 1:200 S 21ST ST STE 400A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1044
Mailing Address - Country:US
Mailing Address - Phone:402-522-6121
Mailing Address - Fax:
Practice Address - Street 1:3620 N 163RD PLZ # STUDIOL
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2164
Practice Address - Country:US
Practice Address - Phone:402-522-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier