Provider Demographics
NPI:1215388962
Name:HOLISTIC HEALING CENTER
Entity Type:Organization
Organization Name:HOLISTIC HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:BELIVEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:732-252-6155
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-0240
Mailing Address - Country:US
Mailing Address - Phone:732-252-6155
Mailing Address - Fax:732-362-4718
Practice Address - Street 1:420 STATE ROUTE 34 STE 317
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2517
Practice Address - Country:US
Practice Address - Phone:732-252-6155
Practice Address - Fax:732-362-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty