Healthcare Provider Details

I. General information

NPI: 1801717079
Provider Name (Legal Business Name): ROOTED LIFE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 CAMDEN PARK DR
COVINGTON LA
70435-0256
US

IV. Provider business mailing address

551 CAMDEN PARK DR
COVINGTON LA
70435-0256
US

V. Phone/Fax

Practice location:
  • Phone: 720-774-0729
  • Fax: 983-203-9632
Mailing address:
  • Phone: 720-774-0729
  • Fax: 983-203-9632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JESSICA GARAUDY
Title or Position: REGISTERED DIETITIAN
Credential: RDN
Phone: 720-774-0729