Healthcare Provider Details

I. General information

NPI: 1578127536
Provider Name (Legal Business Name): HOLISTIC HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 12/02/2021
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 THORN GLEN CT
JACKSONVILLE FL
32208
US

IV. Provider business mailing address

1036 DUNN AVENUE STE 4 #154
JACKSONVILLE FL
32218-6364
US

V. Phone/Fax

Practice location:
  • Phone: 904-297-8877
  • Fax: 904-605-2150
Mailing address:
  • Phone: 904-297-8877
  • Fax: 904-605-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS NATARSHA NICOLE THOMAS
Title or Position: OWNER/OPERATOR
Credential: FNP-BC
Phone: 904-297-8877