Provider Demographics
NPI:1558069187
Name:HOLISTIKA LLC.
Entity Type:Organization
Organization Name:HOLISTIKA LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RMHCI
Authorized Official - Phone:407-455-0529
Mailing Address - Street 1:414 MOHAVE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-7009
Mailing Address - Country:US
Mailing Address - Phone:908-380-6643
Mailing Address - Fax:
Practice Address - Street 1:3074 W LAKE MARY BLVD STE 132
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6749
Practice Address - Country:US
Practice Address - Phone:407-333-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health