MEDICARE: HOLISTIC HEALTHCARE LLC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1144172529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HEALTHCARE LLC.

Provider Business Mailing Address
First Line	:	610 FAIR LN
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-8890
Country	:	US
Telephone Number	:	801-360-9446
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 FAIR LN
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-8890
Country	:	US
Telephone Number	:	801-360-9446
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRODY AYCOCK
Credential	:
Telephone Number	:	801-360-9446

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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