Provider Demographics
NPI:1689318214
Name:THE HOLISTIC HEALING CENTER, LLC
Entity Type:Organization
Organization Name:THE HOLISTIC HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIEFKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LISW
Authorized Official - Phone:319-316-2262
Mailing Address - Street 1:2250 YEARLING DR APT 203
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4469
Mailing Address - Country:US
Mailing Address - Phone:319-316-2262
Mailing Address - Fax:888-375-1723
Practice Address - Street 1:2250 YEARLING DR APT 203
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4469
Practice Address - Country:US
Practice Address - Phone:319-316-2262
Practice Address - Fax:888-375-1723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health