Healthcare Provider Details

I. General information

NPI: 1952019671
Provider Name (Legal Business Name): HUNGER NOT IMPOSSIBLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 CALIFORNIA AVE
VENICE CA
90291-3440
US

IV. Provider business mailing address

628 CALIFORNIA AVE
VENICE CA
90291-3440
US

V. Phone/Fax

Practice location:
  • Phone: 925-708-1970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: ADAM DOLE
Title or Position: COFOUNDER, CHIEF OPERATING OFFICER
Credential:
Phone: 800-936-3022