# BALANCED BITES NUTRITION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114709573
- **Authorized official:** TRACY BENTO RD, CDCES, CSOWM (REGISTERED DIETITIAN)
- **Authorized official phone:** (208) 954-0862

## Contact information

- **Practice address:** 408 S EAGLE RD STE 205, EAGLE, ID 83616-6079
- **Practice address phone:** (208) 954-0862
- **Practice address fax:** (208) 668-8871
- **Mailing address:** 408 S EAGLE RD STE 205, EAGLE, ID 83616-6079
- **Mailing address phone:** (208) 954-0862
- **Mailing address fax:** (208) 668-8871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2023
- **Last updated:** 11/21/2024