Provider Demographics
NPI:1972483188
Name:CHARECE HOUSE OF BEAUTY
Entity type:Organization
Organization Name:CHARECE HOUSE OF BEAUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS
Authorized Official - Prefix:
Authorized Official - First Name:CHARECE
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-604-2502
Mailing Address - Street 1:9318 GEATON PARK PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2682
Mailing Address - Country:US
Mailing Address - Phone:240-604-2502
Mailing Address - Fax:
Practice Address - Street 1:9318 GEATON PARK PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2682
Practice Address - Country:US
Practice Address - Phone:240-604-2502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier