Provider Demographics
NPI:1942881438
Name:IN SEASON HOLISTIC CARE SERVICES LLC
Entity Type:Organization
Organization Name:IN SEASON HOLISTIC CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-BC
Authorized Official - Phone:313-655-6277
Mailing Address - Street 1:17652 MONTAGE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-3807
Mailing Address - Country:US
Mailing Address - Phone:313-655-6277
Mailing Address - Fax:
Practice Address - Street 1:17652 MONTAGE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-3807
Practice Address - Country:US
Practice Address - Phone:313-655-6277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty