Provider Demographics
NPI:1558782557
Name:GOLDEN LIFE NUTRITION, LLC
Entity Type:Organization
Organization Name:GOLDEN LIFE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEMS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CSG
Authorized Official - Phone:720-468-0222
Mailing Address - Street 1:13410 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4602
Mailing Address - Country:US
Mailing Address - Phone:720-468-0222
Mailing Address - Fax:888-972-7310
Practice Address - Street 1:13410 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-4602
Practice Address - Country:US
Practice Address - Phone:720-468-0222
Practice Address - Fax:888-972-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health