Provider Demographics
NPI:1952475147
Name:HOLISTIC HOME HEALTH, CORP.
Entity Type:Organization
Organization Name:HOLISTIC HOME HEALTH, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILAYPHONE
Authorized Official - Middle Name:
Authorized Official - Last Name:THAWNGHMUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-250-8760
Mailing Address - Street 1:4418 SUMMIT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8425
Mailing Address - Country:US
Mailing Address - Phone:614-327-7630
Mailing Address - Fax:
Practice Address - Street 1:24600 CENTER RIDGE RD STE 470
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5679
Practice Address - Country:US
Practice Address - Phone:440-250-8760
Practice Address - Fax:440-250-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2702221Medicaid
OH368148Medicare ID - Type Unspecified