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General NPI Number Information
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NPI Number | 1114007309
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Entity Type | Organization
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Legal Business Name | MID-LAND MEALS, INC.
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3313 CONCORD RD
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City | LAFAYETTE
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State | IN
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Zip | 47909-5127
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Country | US
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Telephone | 765-477-7189
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Fax | 765-477-1598
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Provider Business Mailing Address
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Address Line | 3313 CONCORD RD
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City | LAFAYETTE
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State | IN
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Zip | 47909-5127
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Country | US
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Telephone | 765-477-7189
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Fax | 765-477-1598
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ELAINE JOAN BROVONT
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Credential |
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Telephone | 765-477-7189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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