Provider Demographics
NPI:1841591815
Name:HOLISTIC HAVEN
Entity Type:Organization
Organization Name:HOLISTIC HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN/OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:CHARLYCE
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-230-9603
Mailing Address - Street 1:2600 WESTHOLLOW DR
Mailing Address - Street 2:APT 1721
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1912
Mailing Address - Country:US
Mailing Address - Phone:832-230-9603
Mailing Address - Fax:832-230-9603
Practice Address - Street 1:2600 WESTHOLLOW DR
Practice Address - Street 2:APT 1721
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1912
Practice Address - Country:US
Practice Address - Phone:832-230-9603
Practice Address - Fax:832-230-9603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health