Provider Demographics
NPI:1073210373
Name:TOTAL CARE NUTRITION SERVICES
Entity Type:Organization
Organization Name:TOTAL CARE NUTRITION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:973-219-2055
Mailing Address - Street 1:107 CRENSHAW DR
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-4727
Mailing Address - Country:US
Mailing Address - Phone:973-219-2055
Mailing Address - Fax:
Practice Address - Street 1:107 CRENSHAW DR
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-4727
Practice Address - Country:US
Practice Address - Phone:973-219-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty