Provider Demographics
NPI:1245774595
Name:EMBRACE NUTRITION LLC
Entity Type:Organization
Organization Name:EMBRACE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-562-6222
Mailing Address - Street 1:2029 VANESTA PL
Mailing Address - Street 2:SUITE 16
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-0447
Mailing Address - Country:US
Mailing Address - Phone:785-562-6222
Mailing Address - Fax:
Practice Address - Street 1:2029 VANESTA PL
Practice Address - Street 2:SUITE 16
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-0447
Practice Address - Country:US
Practice Address - Phone:785-562-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS-1115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty