Provider Demographics
NPI:1518120963
Name:NUTRITION FOR LIFE, INC.
Entity Type:Organization
Organization Name:NUTRITION FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CDCES, CHC
Authorized Official - Phone:508-965-1124
Mailing Address - Street 1:1 CRANBERRY PINES RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9720
Mailing Address - Country:US
Mailing Address - Phone:508-965-1124
Mailing Address - Fax:833-407-1388
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1674
Practice Address - Country:US
Practice Address - Phone:508-923-1103
Practice Address - Fax:833-407-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1852133V00000X
133V00000X, 133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty