Provider Demographics
NPI:1407448871
Name:RAISE ME HEALTHY LLC
Entity Type:Organization
Organization Name:RAISE ME HEALTHY LLC
Other - Org Name:NEBRASKA NUTRITION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVALL-AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:402-413-8932
Mailing Address - Street 1:3900 OLD CHENEY ROAD
Mailing Address - Street 2:STE 201 #324
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2709
Mailing Address - Country:US
Mailing Address - Phone:402-413-8932
Mailing Address - Fax:402-413-0705
Practice Address - Street 1:3400 PLANTATION DR STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5199
Practice Address - Country:US
Practice Address - Phone:402-413-8932
Practice Address - Fax:402-413-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty