=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518301126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALOHA NATURAL HEALING CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2013
-----------------------------------------------------
Last Update Date | 04/25/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 161 EAST AVE SUITE 204
-----------------------------------------------------
City | NORWALK
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06851-5710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-286-6172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 161 EAST AVE SUITE 204
-----------------------------------------------------
City | NORWALK
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06851-5710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-286-6172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NATUROPATHIC DOCTOR
-----------------------------------------------------
Name | DR. MARGARET RAGUE
-----------------------------------------------------
Credential | N.D.
-----------------------------------------------------
Telephone | 203-286-6172
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number | 490
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------