Healthcare Provider Details

I. General information

NPI: 1093628349
Provider Name (Legal Business Name): DISTRICT HOLISTIC HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 HARRY THOMAS WAY NE
WASHINGTON DC
20002-2560
US

IV. Provider business mailing address

1550 HARRY THOMAS WAY NE APT 110
WASHINGTON DC
20002-2673
US

V. Phone/Fax

Practice location:
  • Phone: 310-720-0616
  • Fax:
Mailing address:
  • Phone: 310-720-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TOCHUKWU ANSELM DIKE
Title or Position: CEO/NURSE PRACTITIONER
Credential: PMHNP
Phone: 310-720-0616