Provider Demographics
NPI:1386208031
Name:ENLIGHTENED NUTRITION LLC
Entity Type:Organization
Organization Name:ENLIGHTENED NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SCHOMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:989-274-5557
Mailing Address - Street 1:1103 LEDDY ROAD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609
Mailing Address - Country:US
Mailing Address - Phone:989-274-5557
Mailing Address - Fax:
Practice Address - Street 1:1103 LEDDY ROAD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609
Practice Address - Country:US
Practice Address - Phone:989-274-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty