Provider Demographics
NPI:1508476219
Name:HEAT HOLISTIC LIFESTYLE
Entity Type:Organization
Organization Name:HEAT HOLISTIC LIFESTYLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-870-9501
Mailing Address - Street 1:1109 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08063-1441
Mailing Address - Country:US
Mailing Address - Phone:856-870-9501
Mailing Address - Fax:
Practice Address - Street 1:1109 SIMPSON AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08063-1441
Practice Address - Country:US
Practice Address - Phone:856-870-9501
Practice Address - Fax:856-329-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care