Provider Demographics
NPI:1861189706
Name:LAVISH ME BY ADORE
Entity type:Organization
Organization Name:LAVISH ME BY ADORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-686-1186
Mailing Address - Street 1:4925 JACKMAN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3557
Mailing Address - Country:US
Mailing Address - Phone:419-245-8845
Mailing Address - Fax:
Practice Address - Street 1:4925 JACKMAN RD STE 3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3557
Practice Address - Country:US
Practice Address - Phone:419-245-8845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty