Provider Demographics
NPI:1598318818
Name:ACORN DIETETICS, LLC
Entity Type:Organization
Organization Name:ACORN DIETETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORENGO
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, CSR
Authorized Official - Phone:608-284-8642
Mailing Address - Street 1:906 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574-9765
Mailing Address - Country:US
Mailing Address - Phone:608-284-8642
Mailing Address - Fax:
Practice Address - Street 1:906 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574-9765
Practice Address - Country:US
Practice Address - Phone:704-608-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center