| NPI | 1861927626 |
|---|---|
| Former Legal Business Name | NUTRASOURCERD |
| Entity Type | Organization |
| Authorized Contact | CHAYA SOKOL CEO 718-510-6776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital |
| 310400000X Assisted Living Facility | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2023-07-17 |