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General NPI Number Information
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NPI Number | 1861652877
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Entity Type | Organization
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Legal Business Name | CENTER FOR HOLISTIC HEALTH LLC
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Dates
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Enumeration Date | 06/12/2008
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 1000 EUBANK BLVD. NE SUITE H
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2878
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Country | US
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Telephone | 505-298-7371
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Fax | 505-298-7326
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Provider Business Mailing Address
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Address Line | PO BOX 14695
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City | ALBUQUERQUE
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State | NM
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Zip | 87191-4695
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Country | US
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Telephone | 505-298-7371
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Fax | 505-298-7326
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANE H. POLASKY
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Credential | DOM
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Telephone | 505-298-7371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 161RX1
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License Number State | NM
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