Provider Demographics
NPI:1871325274
Name:HOME NUTRITION SUPPORT SOLUTIONS, LLC
Entity type:Organization
Organization Name:HOME NUTRITION SUPPORT SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,RD,LDN,CNSC
Authorized Official - Phone:610-389-9601
Mailing Address - Street 1:140 WOODHILL LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1963
Mailing Address - Country:US
Mailing Address - Phone:610-389-9601
Mailing Address - Fax:
Practice Address - Street 1:140 WOODHILL LN
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1963
Practice Address - Country:US
Practice Address - Phone:610-389-9601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty