Provider Demographics
NPI:1336344571
Name:QUALITY NUTRITION INC.
Entity Type:Organization
Organization Name:QUALITY NUTRITION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HASELHORST
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:618-401-7675
Mailing Address - Street 1:620 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:IL
Mailing Address - Zip Code:62293-1071
Mailing Address - Country:US
Mailing Address - Phone:618-401-7675
Mailing Address - Fax:618-224-2815
Practice Address - Street 1:620 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:IL
Practice Address - Zip Code:62293-1071
Practice Address - Country:US
Practice Address - Phone:618-401-7675
Practice Address - Fax:618-224-2815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty