Provider Demographics
NPI:1093304586
Name:RESILIENT HOLISTIC SERVICES LLC
Entity Type:Organization
Organization Name:RESILIENT HOLISTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:360-224-4579
Mailing Address - Street 1:114 W MAGNOLIA ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4369
Mailing Address - Country:US
Mailing Address - Phone:360-224-4579
Mailing Address - Fax:
Practice Address - Street 1:114 W MAGNOLIA ST STE 501
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4369
Practice Address - Country:US
Practice Address - Phone:360-224-4579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESILIENT ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty