Provider Demographics
NPI:1295318665
Name:HOLISTIC HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:HOLISTIC HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:OLUWASEUN
Authorized Official - Last Name:OGUNNIYI
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:636-409-0296
Mailing Address - Street 1:114 E COLUMBIA ST STE B2
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-3103
Mailing Address - Country:US
Mailing Address - Phone:573-482-0173
Mailing Address - Fax:573-330-5458
Practice Address - Street 1:114 E COLUMBIA ST STE B2
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-3103
Practice Address - Country:US
Practice Address - Phone:573-482-0173
Practice Address - Fax:573-330-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health