Provider Demographics
NPI:1568647071
Name:ELIZABETH L FELLOWS HOLISTIC HEALTH LLC
Entity Type:Organization
Organization Name:ELIZABETH L FELLOWS HOLISTIC HEALTH LLC
Other - Org Name:CENTER POINT HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LANCASTER
Authorized Official - Last Name:FELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LAC
Authorized Official - Phone:301-277-9020
Mailing Address - Street 1:6525 BELCREST RD
Mailing Address - Street 2:SUITE 414
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2003
Mailing Address - Country:US
Mailing Address - Phone:301-277-9020
Mailing Address - Fax:301-277-9023
Practice Address - Street 1:6525 BELCREST RD
Practice Address - Street 2:SUITE 414
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2003
Practice Address - Country:US
Practice Address - Phone:301-277-9020
Practice Address - Fax:301-277-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01526261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty