Provider Demographics
NPI:1245808500
Name:TAKE CONTROL, INC
Entity type:Organization
Organization Name:TAKE CONTROL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-746-2970
Mailing Address - Street 1:PO BOX 9132
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-9132
Mailing Address - Country:US
Mailing Address - Phone:800-746-2970
Mailing Address - Fax:800-746-2970
Practice Address - Street 1:116 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4204
Practice Address - Country:US
Practice Address - Phone:800-746-2970
Practice Address - Fax:800-746-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty