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General NPI Number Information
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NPI Number | 1790296804
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Entity Type | Organization
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Legal Business Name | LIVING RENEWED, INC.
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1862 AUBURN RD STE 118-Q5
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City | DACULA
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State | GA
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Zip | 30019-1676
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Country | US
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Telephone | 770-744-1995
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Fax | 770-766-4439
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Provider Business Mailing Address
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Address Line | PO BOX 1715
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City | BUFORD
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State | GA
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Zip | 30515-8715
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Country | US
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Telephone | 770-744-1995
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, OWNER
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Name | CHERYL MITCHELL
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Credential | MS, RDN, LD, IFNCP
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Telephone | 770-744-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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