Provider Demographics
NPI:1144614975
Name:HOLISTIC HOME CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:HOLISTIC HOME CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-966-3356
Mailing Address - Street 1:P.O. BOX 100
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:OK
Mailing Address - Zip Code:74941
Mailing Address - Country:US
Mailing Address - Phone:918-966-3356
Mailing Address - Fax:918-966-3362
Practice Address - Street 1:102 S.E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:KEOTA
Practice Address - State:OK
Practice Address - Zip Code:74941
Practice Address - Country:US
Practice Address - Phone:918-966-3356
Practice Address - Fax:918-966-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC8043251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health