MEDICARE: STRUCTURED HOLISTIC SERV SHS&S

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376313767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRUCTURED HOLISTIC SERV SHS&S

Provider Business Mailing Address
First Line	:	409 S DIVISION ST
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-3930
Country	:	US
Telephone Number	:	731-504-2949
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 S DIVISION ST
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-3930
Country	:	US
Telephone Number	:	731-504-2949
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LYNNEL TOWNSEND
Credential	:
Telephone Number	:	731-504-2949

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	02/01/2024

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Directions to “STRUCTURED HOLISTIC SERV SHS&S ” Practice Location

Language	Start Address	Practice Location

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