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General NPI Number Information
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NPI Number | 1386140184
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Entity Type | Organization
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Legal Business Name | GRAND RISING HOLISTIC WELLNESS CENTER
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 19670 SW EAGLE DR
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City | DUNNELLON
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State | FL
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Zip | 34431-3650
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Country | US
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Telephone | 352-872-6024
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Fax |
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Provider Business Mailing Address
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Address Line | 19670 SW EAGLE DR
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City | DUNNELLON
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State | FL
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Zip | 34431-3650
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Country | US
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Telephone | 352-872-6024
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Fax |
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Authorized Official
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Title or Position | NATURAL HEALTH PRACTITIONER
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Name | CALVIS WILLIAMSON
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Credential | M.S.
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Telephone | 352-872-6024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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