Healthcare Provider Details

I. General information

NPI: 1700703071
Provider Name (Legal Business Name): HOLISTIC PRO HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10007 EVENTIDE TRL
PARRISH FL
34219-1478
US

IV. Provider business mailing address

10007 EVENTIDE TRL
PARRISH FL
34219-1478
US

V. Phone/Fax

Practice location:
  • Phone: 863-274-0189
  • Fax:
Mailing address:
  • Phone: 863-274-0189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CARLENE JAMES-OTTEY
Title or Position: MANAGER
Credential: RN
Phone: 863-274-0189