Healthcare Provider Details

I. General information

NPI: 1225324403
Provider Name (Legal Business Name): HOLISTIC VIEW THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2011
Last Update Date: 06/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 E GRIFFIN PKWY STE G
MISSION TX
78572-3110
US

IV. Provider business mailing address

1922 E GRIFFIN PKWY STE G
MISSION TX
78572-3110
US

V. Phone/Fax

Practice location:
  • Phone: 956-802-2891
  • Fax:
Mailing address:
  • Phone: 956-802-2891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number112481
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number112481
License Number StateTX

VIII. Authorized Official

Name: MRS. YADIRA DENISSE MANCHA
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR
Phone: 956-802-2891