Provider Demographics
NPI:1356477848
Name:HIGH MEADOW HEALTHY LIVING, LLC
Entity type:Organization
Organization Name:HIGH MEADOW HEALTHY LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MACLEOD
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, LDN
Authorized Official - Phone:919-880-4468
Mailing Address - Street 1:3711 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-9600
Mailing Address - Country:US
Mailing Address - Phone:919-880-4468
Mailing Address - Fax:
Practice Address - Street 1:3711 HIGH MEADOW RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-9600
Practice Address - Country:US
Practice Address - Phone:919-880-4468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRD#621562, L001042133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty