Provider Demographics
NPI:1376313767
Name:STRUCTURED HOLISTIC SERV SHS&S
Entity Type:Organization
Organization Name:STRUCTURED HOLISTIC SERV SHS&S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-504-2949
Mailing Address - Street 1:409 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-3930
Mailing Address - Country:US
Mailing Address - Phone:731-504-2949
Mailing Address - Fax:
Practice Address - Street 1:409 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-3930
Practice Address - Country:US
Practice Address - Phone:731-504-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care