Provider Demographics
NPI:1720523210
Name:HOLISTIC HOSPICE INC
Entity Type:Organization
Organization Name:HOLISTIC HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAHR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-231-3130
Mailing Address - Street 1:3422 W HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-1208
Mailing Address - Country:US
Mailing Address - Phone:414-231-3130
Mailing Address - Fax:414-239-8544
Practice Address - Street 1:3422 W HOWARD AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-1208
Practice Address - Country:US
Practice Address - Phone:414-231-3130
Practice Address - Fax:414-239-8544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based