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General NPI Number Information
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NPI Number | 1598319378
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Entity Type | Organization
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Legal Business Name | ENLIGHTENMENT ENTREPRENEURIAL ENTERPRISES INC.
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 7000 KENNEDY BLVD E UNIT 47D
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City | GUTTENBERG
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State | NJ
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Zip | 07093-4862
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Country | US
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Telephone | 201-881-8281
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 KENNEDY BLVD E APT 47D
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City | GUTTENBERG
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State | NJ
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Zip | 07093-4862
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Country | US
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Telephone | 201-881-8281
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA GRINSTEAD
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Credential |
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Telephone | 917-292-1802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | 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 | 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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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 226000000X
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Taxonomy Name | Recreational Therapist Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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