Provider Demographics
NPI:1851663132
Name:SALUBRIOUS, INC
Entity Type:Organization
Organization Name:SALUBRIOUS, INC
Other - Org Name:INSHAPEMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-543-8900
Mailing Address - Street 1:2685 PALMER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1708
Mailing Address - Country:US
Mailing Address - Phone:406-543-8900
Mailing Address - Fax:
Practice Address - Street 1:2685 PALMER ST
Practice Address - Street 2:SUITE A
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1708
Practice Address - Country:US
Practice Address - Phone:406-543-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEPH PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty