Provider Demographics
NPI:1679396998
Name:HOLISTIC CARE
Entity type:Organization
Organization Name:HOLISTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SHALIA
Authorized Official - Middle Name:AINSWORTH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-554-1278
Mailing Address - Street 1:310 ORCHARD WAY
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-4602
Mailing Address - Country:US
Mailing Address - Phone:504-554-1278
Mailing Address - Fax:
Practice Address - Street 1:310 ORCHARD WAY
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-4602
Practice Address - Country:US
Practice Address - Phone:504-554-1278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center