Provider Demographics
NPI:1184227522
Name:HOLISTIC EDGE INC
Entity Type:Organization
Organization Name:HOLISTIC EDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-203-9588
Mailing Address - Street 1:2330 SCENIC HWY S
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3115
Mailing Address - Country:US
Mailing Address - Phone:678-203-9588
Mailing Address - Fax:
Practice Address - Street 1:3401 NORMAN BERRY DR STE 264B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30344-5102
Practice Address - Country:US
Practice Address - Phone:678-203-9588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMELIA R NARAIN NP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health