Provider Demographics
NPI:1619410917
Name:HOLISTIC FAMILY CARE, PLLC
Entity Type:Organization
Organization Name:HOLISTIC FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HANISH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-881-8189
Mailing Address - Street 1:8149 N 87TH PL
Mailing Address - Street 2:134
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4399
Mailing Address - Country:US
Mailing Address - Phone:602-881-8189
Mailing Address - Fax:
Practice Address - Street 1:8149 N 87TH PL
Practice Address - Street 2:134
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4399
Practice Address - Country:US
Practice Address - Phone:602-881-8189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care