Provider Demographics
NPI:1881825230
Name:KEEP IT HEALTHY, INC.
Entity Type:Organization
Organization Name:KEEP IT HEALTHY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DETRICK
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD LDN
Authorized Official - Phone:336-337-7484
Mailing Address - Street 1:612 PASTEUR DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1149
Mailing Address - Country:US
Mailing Address - Phone:336-337-7484
Mailing Address - Fax:336-855-1843
Practice Address - Street 1:612 PASTEUR DR
Practice Address - Street 2:SUITE 108
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1149
Practice Address - Country:US
Practice Address - Phone:336-337-7484
Practice Address - Fax:336-855-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002735133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty