Healthcare Provider Details

I. General information

NPI: 1033689906
Provider Name (Legal Business Name): CENTER FOR JOYFUL EATING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 WESTGATE DR STE 306
DURHAM NC
27707-2568
US

IV. Provider business mailing address

2013 N LAKESHORE DR
CHAPEL HILL NC
27514-2025
US

V. Phone/Fax

Practice location:
  • Phone: 919-386-9848
  • Fax:
Mailing address:
  • Phone: 919-386-9848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MRS. MONICA GULISANO
Title or Position: PRESIDENT
Credential: RDN, LDN
Phone: 919-386-9848