=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659282143
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMOUS SALADS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2026
-----------------------------------------------------
Last Update Date | 09/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1670 JASPER ST UNIT H
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80011-4662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-905-5184
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2577 S TRUCKEE WAY
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80013-5925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-725-1399
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | JEANNINE DICKENS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-725-1399
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------