Healthcare Provider Details

I. General information

NPI: 1114312386
Provider Name (Legal Business Name): HOLISTIC HOME HEALTH CARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2015
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

8777 W FOREST HOME AVE
GREENFIELD WI
53228-3421
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 TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SAHR LEBBIE
Title or Position: ADMINISTRATOR
Credential:
Phone: 563-513-7556