Provider Demographics
NPI:1902344583
Name:LAS CRUCES NUTRITION FOR HEALTH MANAGEMENT
Entity Type:Organization
Organization Name:LAS CRUCES NUTRITION FOR HEALTH MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMNADA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALOPEK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LD
Authorized Official - Phone:575-642-0081
Mailing Address - Street 1:2875 MESILLA ACRES RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-4214
Mailing Address - Country:US
Mailing Address - Phone:575-642-0081
Mailing Address - Fax:
Practice Address - Street 1:2875 MESILLA ACRES RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-4214
Practice Address - Country:US
Practice Address - Phone:575-642-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLD0928133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty