Healthcare Provider Details

I. General information

NPI: 1396527917
Provider Name (Legal Business Name): FOOD FOR THOUGHT - A WELLNESS COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13898 VANCANZA DR
VENICE FL
34293
US

IV. Provider business mailing address

12161 MERCADO DR PMB 409
VENICE FL
34293-4399
US

V. Phone/Fax

Practice location:
  • Phone: 941-347-0623
  • Fax: 941-208-9398
Mailing address:
  • Phone: 941-347-0623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. AUDRA GLUNT
Title or Position: OWNER
Credential: APRN, DNP
Phone: 941-347-0623