Provider Demographics
NPI:1316186158
Name:NUTRITION BLISS LLC
Entity Type:Organization
Organization Name:NUTRITION BLISS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FLAHART
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:602-821-5560
Mailing Address - Street 1:6126 E JOAN DE ARC AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3831
Mailing Address - Country:US
Mailing Address - Phone:602-821-5560
Mailing Address - Fax:
Practice Address - Street 1:6126 E JOAN DE ARC AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3831
Practice Address - Country:US
Practice Address - Phone:602-821-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ978513133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty