Provider Demographics
NPI:1669624342
Name:NOURISHING SUCCESS INCORPORATED
Entity type:Organization
Organization Name:NOURISHING SUCCESS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAGGIANI
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD/N
Authorized Official - Phone:561-392-2262
Mailing Address - Street 1:72 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5427
Mailing Address - Country:US
Mailing Address - Phone:561-392-2262
Mailing Address - Fax:561-968-5752
Practice Address - Street 1:72 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5427
Practice Address - Country:US
Practice Address - Phone:561-392-2262
Practice Address - Fax:561-968-5752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2610261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center