Provider Demographics
NPI:1780180331
Name:HOLISTIC LOVING & CARE LLC
Entity Type:Organization
Organization Name:HOLISTIC LOVING & CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JADE
Authorized Official - Middle Name:DELYSE
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:301-325-9212
Mailing Address - Street 1:6310 GILBRALTER CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5311
Mailing Address - Country:US
Mailing Address - Phone:301-325-9212
Mailing Address - Fax:
Practice Address - Street 1:6310 GILBRALTER CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5311
Practice Address - Country:US
Practice Address - Phone:301-325-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP52323164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty