Provider Demographics
NPI:1750826418
Name:A TASTE OF HEALTH, LLC
Entity Type:Organization
Organization Name:A TASTE OF HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RICCI-LEE
Authorized Official - Middle Name:MICHAL
Authorized Official - Last Name:HOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:520-820-9916
Mailing Address - Street 1:850 N KOLB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1333
Mailing Address - Country:US
Mailing Address - Phone:520-257-3881
Mailing Address - Fax:520-844-1110
Practice Address - Street 1:850 N KOLB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1333
Practice Address - Country:US
Practice Address - Phone:520-257-3881
Practice Address - Fax:520-844-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86054333133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty