Provider Demographics
NPI:1740918994
Name:BEATITUD WELLNESS LLC
Entity type:Organization
Organization Name:BEATITUD WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGUERRE
Authorized Official - Suffix:
Authorized Official - Credentials:DHSC, RDN, MS
Authorized Official - Phone:732-290-4104
Mailing Address - Street 1:485C US HIGHWAY 1 # 100350
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3037
Mailing Address - Country:US
Mailing Address - Phone:732-290-4104
Mailing Address - Fax:
Practice Address - Street 1:485C US HIGHWAY 1 # 100350
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3037
Practice Address - Country:US
Practice Address - Phone:732-290-4104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Single Specialty