Provider Demographics
NPI:1902526825
Name:NOURISH & LIV LLC
Entity Type:Organization
Organization Name:NOURISH & LIV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NAPOLEON
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:845-518-2047
Mailing Address - Street 1:110 ANTHEM WAY
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2280
Mailing Address - Country:US
Mailing Address - Phone:845-518-2047
Mailing Address - Fax:
Practice Address - Street 1:110 ANTHEM WAY
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2280
Practice Address - Country:US
Practice Address - Phone:267-371-7840
Practice Address - Fax:484-848-5166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADN006802OtherLDN