Provider Demographics
NPI:1891743597
Name:LOVE R US CHILD AND NUTRITION SERVICES
Entity Type:Organization
Organization Name:LOVE R US CHILD AND NUTRITION SERVICES
Other - Org Name:MEDICAL NUTRITION THERAPY CONSULTANT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,LD
Authorized Official - Phone:816-965-0652
Mailing Address - Street 1:1403 ESSEX CT
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-9091
Mailing Address - Country:US
Mailing Address - Phone:816-331-2044
Mailing Address - Fax:816-767-0925
Practice Address - Street 1:10500 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-1624
Practice Address - Country:US
Practice Address - Phone:816-767-0925
Practice Address - Fax:816-767-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004034948133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty