Provider Demographics
NPI:1841649860
Name:HOLISTICARE LLC
Entity type:Organization
Organization Name:HOLISTICARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORAINE
Authorized Official - Middle Name:KINGSLEY
Authorized Official - Last Name:FOXHOVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-820-3620
Mailing Address - Street 1:8305 W HIGHWAY 71 STE 220
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8302
Mailing Address - Country:US
Mailing Address - Phone:512-820-3620
Mailing Address - Fax:
Practice Address - Street 1:4107 STONECROFT DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-3138
Practice Address - Country:US
Practice Address - Phone:512-820-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care