Healthcare Provider Details

I. General information

NPI: 1720027139
Provider Name (Legal Business Name): HOLISTIC HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 JAMES DR W STE 138
SAINT ROSE LA
70087-4029
US

IV. Provider business mailing address

110 JAMES DR W STE 138
SAINT ROSE LA
70087-4028
US

V. Phone/Fax

Practice location:
  • Phone: 504-465-3800
  • Fax: 504-465-3657
Mailing address:
  • Phone: 504-465-3800
  • Fax: 504-465-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2203781180
License Number StateLA

VIII. Authorized Official

Name: FREIDA BROOKS HOWARD
Title or Position: CEO
Credential: RN, FNP, MPH
Phone: 504-465-3800