Healthcare Provider Details

I. General information

NPI: 1720523210
Provider Name (Legal Business Name): HOLISTIC HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8777 W FOREST HOME AVE
GREENFIELD WI
53228-3421
US

IV. Provider business mailing address

3422 W HOWARD AVE
GREENFIELD WI
53221-1208
US

V. Phone/Fax

Practice location:
  • Phone: 414-231-3130
  • Fax: 414-239-8544
Mailing address:
  • Phone: 414-231-3130
  • Fax: 414-239-8544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAHR LEBBIE
Title or Position: PRESIDENT
Credential:
Phone: 414-231-3130