Beautiful Grace, LLC

NPI #1811513765 in Mer Rouge, Louisiana

Provider Information

NPI Number: 1811513765
Entity Type: Organization
Organization Name: Beautiful Grace, LLC
Primary Specialty: Prosthetic/Orthotic Supplier
Enumeration Date: Jun 17, 2020
Last Updated: Jun 17, 2020

Practice Location

Address: 100 HANDY HILL RD
City: Mer Rouge
State: Louisiana
ZIP Code: 71261-6900
Phone: (318) 239-1312

Authorized Official

Name: SHANTEAU SYLVESTER
Title: CRANIAL PROSTHESIS SPECIALIST
Phone: (318) 239-1312

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Medical Specialty — Medical Specialty	261QM2500X
Durable Medical Equipment & Medical Supplies	332B00000X
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Prosthetic/Orthotic Supplier	335E00000X	Primary

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