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General NPI Number Information
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NPI Number | 1376008375
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Entity Type | Organization
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Legal Business Name | THREE TREASURES HOLISTIC CARE, LLC
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 2727 B NW 43RD ST SUITE B
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone | 352-727-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 825 NE 4TH AVE
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTITIONER/MANAGER/OWNER
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Name | DAMITA AUTRECIA HARTZ
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Credential |
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Telephone | 352-727-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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