Provider Demographics
NPI:1992903587
Name:HEALTHY DIETS, LLC
Entity type:Organization
Organization Name:HEALTHY DIETS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:TEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:919-870-1001
Mailing Address - Street 1:3612 SHANNON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6333
Mailing Address - Country:US
Mailing Address - Phone:919-870-1001
Mailing Address - Fax:919-516-0673
Practice Address - Street 1:3612 SHANNON RD STE 103
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6333
Practice Address - Country:US
Practice Address - Phone:919-870-1001
Practice Address - Fax:919-516-0673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000600133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty