Healthcare Provider Details

I. General information

NPI: 1548113459
Provider Name (Legal Business Name): HOLISTICO. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 1/2 NORTH AVE
YOUNGSTOWN OH
44502-1145
US

IV. Provider business mailing address

2315 CORONADO AVE
YOUNGSTOWN OH
44504-1310
US

V. Phone/Fax

Practice location:
  • Phone: 330-503-7550
  • Fax:
Mailing address:
  • Phone: 330-503-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY MARIE GORE
Title or Position: CO-OWNER
Credential: BSN
Phone: 330-503-7550