Provider Demographics
NPI:1407147473
Name:APPLE A DAY NUTRITION SERVICES
Entity Type:Organization
Organization Name:APPLE A DAY NUTRITION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:DALENE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, MS
Authorized Official - Phone:310-462-1012
Mailing Address - Street 1:5720 LEMON AVENUE
Mailing Address - Street 2:UNIT # H
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-4772
Mailing Address - Country:US
Mailing Address - Phone:310-462-1012
Mailing Address - Fax:323-952-4303
Practice Address - Street 1:5720 LEMON AVE
Practice Address - Street 2:UNIT # H
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-4771
Practice Address - Country:US
Practice Address - Phone:310-462-1012
Practice Address - Fax:323-952-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133N00000X133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty