Provider Demographics
NPI:1013515063
Name:HOLISITC CARE LLC
Entity Type:Organization
Organization Name:HOLISITC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKARIM
Authorized Official - Middle Name:MOALLIM
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-205-0555
Mailing Address - Street 1:4720 7TH AVE S STE E
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-7254
Mailing Address - Country:US
Mailing Address - Phone:701-552-0856
Mailing Address - Fax:
Practice Address - Street 1:4720 7TH AVE S STE E
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7254
Practice Address - Country:US
Practice Address - Phone:701-552-0856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty