Organization Name: | PS NUTRITION |
NPI Number: | 1063645240 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILIP T SKAFF (OWNER) |
Mailing Address: | 2457 Newton St Denver |
State: | CO US |
Postal Code: | 802114443 |
Phone Number: | 3039108997 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2009 |
NPI Last Update Date: | 09/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 1035109 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |