Healthcare Provider Details

I. General information

NPI: 1568387645
Provider Name (Legal Business Name): HOLSTROM HOMECARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 WASHINGTON ST
LOCKPORT NY
14094-2130
US

IV. Provider business mailing address

294 WASHINGTON ST
LOCKPORT NY
14094-2130
US

V. Phone/Fax

Practice location:
  • Phone: 716-870-8158
  • Fax: 716-455-2236
Mailing address:
  • Phone: 716-870-8158
  • Fax: 716-455-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN J HOLSTROM
Title or Position: INDEPENDENT SERVICE COORDINATOR
Credential: BSW
Phone: 716-870-8158