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General NPI Number Information
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NPI Number | 1932916541
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Entity Type | Organization
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Legal Business Name | HOLISTICATS LLC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2480 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1152
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Country | US
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Telephone | 810-444-0967
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 TROTWOOD LN
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City | FLINT
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State | MI
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Zip | 48507-3711
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Country | US
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Telephone | 810-931-5536
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. MICHELLE MARIE CORTEZ
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Credential | RMA, BSHA, CHW
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Telephone | 810-444-0967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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