# EAT WELL FOR LIFE, LLC

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

## Provider details

- **NPI number:** 1568850337
- **Authorized official:** HEIDI LUCAS RD, LDN (OWNER/REGISTERED DIETITIAN)
- **Authorized official phone:** (717) 372-6687

## Contact information

- **Practice address:** 35 RAGGED EDGE RD, CHAMBERSBURG, PA 17202-4450
- **Practice address phone:** (717) 372-6687
- **Practice address fax:** (717) 446-0033
- **Mailing address:** 138 ROLAND AVE, CHAMBERSBURG, PA 17201-1444
- **Mailing address phone:** (717) 372-6687
- **Mailing address fax:** (717) 446-0033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/02/2015
- **Last updated:** 01/13/2016