Provider Demographics
NPI:1184470999
Name:PRANAYAMA HOLISTIC HEALTH
Entity type:Organization
Organization Name:PRANAYAMA HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOJISOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-479-5145
Mailing Address - Street 1:16 S RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-7759
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 S RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7759
Practice Address - Country:US
Practice Address - Phone:609-479-5145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)