Provider Demographics
NPI:1649000167
Name:SOLACE HOLISTIC CARE LLC
Entity type:Organization
Organization Name:SOLACE HOLISTIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISHMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-831-2649
Mailing Address - Street 1:3443 CLOVER RIDGE CT APT 104
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6636
Mailing Address - Country:US
Mailing Address - Phone:915-330-2985
Mailing Address - Fax:
Practice Address - Street 1:70 BIRCH ALLEY
Practice Address - Street 2:SUITE 207
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440
Practice Address - Country:US
Practice Address - Phone:937-343-6737
Practice Address - Fax:915-330-2985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty