Provider Demographics
NPI:1811771918
Name:HOLISTIC WELL INC
Entity type:Organization
Organization Name:HOLISTIC WELL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:781-384-1327
Mailing Address - Street 1:44 FITCHBURG RD APT 401
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1247
Mailing Address - Country:US
Mailing Address - Phone:781-800-3828
Mailing Address - Fax:
Practice Address - Street 1:5297 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1793
Practice Address - Country:US
Practice Address - Phone:781-384-1327
Practice Address - Fax:781-205-1564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty