Provider Demographics
NPI:1326423104
Name:HOLISTIC HOME HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:HOLISTIC HOME HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:920-296-7990
Mailing Address - Street 1:812 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:DE FOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-3073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:812 CLOVER LN
Practice Address - Street 2:
Practice Address - City:DE FOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-3073
Practice Address - Country:US
Practice Address - Phone:920-296-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center