MEDICARE: HOLISTIC RESOLUTIONS INC

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	251S00000X	Community/Behavioral Health Agency		LA

General Provider Information

NPI Number	:	1487941670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC RESOLUTIONS INC

Provider Business Mailing Address
First Line	:	1504 PRYTANIA ST
Second Line	:	SUITE A
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4462
Country	:	US
Telephone Number	:	504-595-3405
Fax Number	:	504-528-2515

Provider Business Practice Location Address
First Line	:	1504 PRYTANIA ST
Second Line	:	SUITE A
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4462
Country	:	US
Telephone Number	:	504-595-3405
Fax Number	:	504-528-2515

Authorized Official
Title or Position	:	CHEIF EXECUTIVE OFFICER
Name	:	MS. DEIRDRE F JOHNSON
Credential	:	M.ED
Telephone Number	:	504-234-1958

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/07/2011

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