Provider Demographics
NPI:1972151553
Name:CVWELLBEING
Entity Type:Organization
Organization Name:CVWELLBEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLES
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:508-965-0875
Mailing Address - Street 1:510 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1339
Mailing Address - Country:US
Mailing Address - Phone:207-370-7787
Mailing Address - Fax:
Practice Address - Street 1:510 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1339
Practice Address - Country:US
Practice Address - Phone:207-370-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CVWELLBEING DBA CVBRANDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-28
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty