Provider Demographics
NPI:1619750239
Name:WHOLE DIETETICS LLC
Entity Type:Organization
Organization Name:WHOLE DIETETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SPLINTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-883-2838
Mailing Address - Street 1:1887 WHITNEY MESA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2069
Mailing Address - Country:US
Mailing Address - Phone:702-883-2838
Mailing Address - Fax:
Practice Address - Street 1:3460 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8241
Practice Address - Country:US
Practice Address - Phone:702-883-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty