Provider Demographics
NPI:1780048330
Name:CHEERFUL HABITS LLC
Entity type:Organization
Organization Name:CHEERFUL HABITS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:LOICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARC
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:770-861-9176
Mailing Address - Street 1:2470 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 300 PMB 5202
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8613
Mailing Address - Country:US
Mailing Address - Phone:770-861-9176
Mailing Address - Fax:
Practice Address - Street 1:2470 WINDY HILL RD SE
Practice Address - Street 2:SUITE 300 PMB 5202
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8613
Practice Address - Country:US
Practice Address - Phone:770-861-9176
Practice Address - Fax:404-465-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16028312261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service