Healthcare Provider Details

I. General information

NPI: 1952475147
Provider Name (Legal Business Name): HOLISTIC HOME HEALTH, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24600 CENTER RIDGE RD STE 470
WESTLAKE OH
44145-5679
US

IV. Provider business mailing address

4418 SUMMIT VIEW RD
DUBLIN OH
43016-8425
US

V. Phone/Fax

Practice location:
  • Phone: 440-250-8760
  • Fax: 440-250-8762
Mailing address:
  • Phone: 614-327-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: VILAYPHONE THAWNGHMUNG
Title or Position: PRESIDENT
Credential:
Phone: 440-250-8760