Provider Demographics
NPI:1881442218
Name:HOLISTIC OT THERAPY SOLUTION LLC
Entity type:Organization
Organization Name:HOLISTIC OT THERAPY SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L, C/NDT
Authorized Official - Phone:786-387-4398
Mailing Address - Street 1:21819 MORGAN PARK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4851
Mailing Address - Country:US
Mailing Address - Phone:786-387-4398
Mailing Address - Fax:
Practice Address - Street 1:21819 MORGAN PARK LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4851
Practice Address - Country:US
Practice Address - Phone:786-387-4398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health