MEDICARE: HOLISTIC HOME HEALTH CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	2203781180	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1612511	OTHER	LA	WAIVER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1462179	OTHER	LA	LTC

General Provider Information

NPI Number	:	1720027139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	110 JAMES DR W STE 138
Second Line	:
City	:	SAINT ROSE
State	:	LA
Zip	:	70087-4028
Country	:	US
Telephone Number	:	504-465-3800
Fax Number	:	504-465-3657

Provider Business Practice Location Address
First Line	:	110 JAMES DR W STE 138
Second Line	:
City	:	SAINT ROSE
State	:	LA
Zip	:	70087-4029
Country	:	US
Telephone Number	:	504-465-3800
Fax Number	:	504-465-3657

Authorized Official
Title or Position	:	CEO
Name	:	FREIDA BROOKS HOWARD
Credential	:	RN, FNP, MPH
Telephone Number	:	504-465-3800

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	11/04/2013

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