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General NPI Number Information
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NPI Number | 1437981511
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Entity Type | Organization
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Legal Business Name | LIFEFUL AGING, LLC
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 11211 PROSPERITY FARMS RD STE A101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3479
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Country | US
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Telephone | 480-813-9989
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Fax |
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Provider Business Mailing Address
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Address Line | 11211 PROSPERITY FARMS RD STE A101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3479
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Country | US
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Telephone | 480-813-9989
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | BETTY HARBOLIC
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Credential | MS, RDN
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Telephone | 917-449-2990
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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 | 133VN1101X
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Taxonomy Name | Gerontological Nutrition Registered Dietitian
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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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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