Healthcare Provider Details

I. General information

NPI: 1497194187
Provider Name (Legal Business Name): FOREVER LIVING DELICIOUSLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1072 MOUNTAIN OAK PL
NEWBURY PARK CA
91320-3569
US

IV. Provider business mailing address

1072 MOUNTAIN OAK PL
NEWBURY PARK CA
91320-3569
US

V. Phone/Fax

Practice location:
  • Phone: 303-913-4573
  • Fax:
Mailing address:
  • Phone: 303-913-4573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: KATIE ARMIJO
Title or Position: CEO/NUTRITON COACH
Credential:
Phone: 303-913-4573