Provider Demographics
NPI:1083877757
Name:HOLISTIC HEALTH GROUP
Entity Type:Organization
Organization Name:HOLISTIC HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:B
Authorized Official - Last Name:OJEDA DAUILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-249-2585
Mailing Address - Street 1:P.O. BOX 326
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00704
Mailing Address - Country:UM
Mailing Address - Phone:787-537-7555
Mailing Address - Fax:787-537-7104
Practice Address - Street 1:PORTO BELLO TOWN CENTER SUITE 14
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-537-7555
Practice Address - Fax:787-537-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
PR261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)