MEDICARE: HOLOS INTEGRATIVE HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QP2300X	Primary Care Clinic/Center
3	133NN1002X	Nutrition Education Nutritionist
4	261QC1500X	Community Health Clinic/Center
5	261QC1800X	Corporate Health Clinic/Center
6	133N00000X	Nutritionist
7	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1033777370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLOS INTEGRATIVE HEALTHCARE

Provider Business Mailing Address
First Line	:	801 SHELBY ST STE 212
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-1163
Country	:	US
Telephone Number	:	317-558-9410
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 SHELBY ST STE 212
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-1163
Country	:	US
Telephone Number	:	317-558-9410
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	SARAH ELIZABETH STILZ
Credential	:
Telephone Number	:	317-558-9410

Provider Enumeration Date	:	06/02/2019
Last Update Date	:	11/05/2024

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