| Organization Name: | MARANATHA NATURAL LIVING LLC |
| NPI Number: | 1154775104 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GABRIELLA RUS-NEACSU (OWNER) |
| Mailing Address: | 1860 Weatherhead Hollow Rd Guilford |
| State: | VT US |
| Postal Code: | 053019821 |
| Phone Number: | 8024511966 |
| Fax Number: | 8027381066 |
| NPI Enumeration Date: | 04/15/2016 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 101.0119517 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |