Provider Demographics
NPI:1720027139
Name:HOLISTIC HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:HOLISTIC HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FREIDA
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP, MPH
Authorized Official - Phone:504-465-3800
Mailing Address - Street 1:110 JAMES DR W STE 138
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-4028
Mailing Address - Country:US
Mailing Address - Phone:504-465-3800
Mailing Address - Fax:504-465-3657
Practice Address - Street 1:110 JAMES DR W STE 138
Practice Address - Street 2:
Practice Address - City:SAINT ROSE
Practice Address - State:LA
Practice Address - Zip Code:70087-4029
Practice Address - Country:US
Practice Address - Phone:504-465-3800
Practice Address - Fax:504-465-3657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203781180251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1612511OtherWAIVER
LA1402010Medicaid
LA1462179OtherLTC
LA1612511OtherWAIVER