Provider Demographics
NPI:1154653582
Name:TORI HEALING ARTS AND NUTRITION
Entity Type:Organization
Organization Name:TORI HEALING ARTS AND NUTRITION
Other - Org Name:TORI HEALTH AND NUTRITION CLUB
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-982-9090
Mailing Address - Street 1:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77641-1376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3100 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2734
Practice Address - Country:US
Practice Address - Phone:409-982-9090
Practice Address - Fax:409-982-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109921302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization