MEDICARE: HOLISTIC HEALTHCARE AGENCY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639935414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HEALTHCARE AGENCY

Provider Business Mailing Address
First Line	:	276 TOWERVIEW DR W
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9615
Country	:	US
Telephone Number	:	407-255-3436
Fax Number	:

Provider Business Practice Location Address
First Line	:	276 TOWERVIEW DR W
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9615
Country	:	US
Telephone Number	:	407-255-3436
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	WALKY SAINTIL
Credential	:
Telephone Number	:	407-255-3436

Provider Enumeration Date	:	02/28/2024
Last Update Date	:	02/28/2024

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