Provider Demographics
NPI:1467833038
Name:HOLISTIC HEALTHCARE
Entity Type:Organization
Organization Name:HOLISTIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONADAB
Authorized Official - Middle Name:
Authorized Official - Last Name:ERHAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-222-2779
Mailing Address - Street 1:65 EUTAW AVE
Mailing Address - Street 2:# 3
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-2136
Mailing Address - Country:US
Mailing Address - Phone:857-222-2779
Mailing Address - Fax:
Practice Address - Street 1:65 EUTAW AVE
Practice Address - Street 2:# 3
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-2136
Practice Address - Country:US
Practice Address - Phone:857-222-2779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2288169251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health