MEDICARE: HOLISTIC HEALING AVENUES, 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	251S00000X	Community/Behavioral Health Agency		OH

General Provider Information

NPI Number	:	1679892327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HEALING AVENUES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 6732
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-0732
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 SUMMIT RD STE 113
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-2818
Country	:	US
Telephone Number	:	513-693-0432
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. TANYA RACHELLE TOYER
Credential	:	PCC-S
Telephone Number	:	513-884-8681

Provider Enumeration Date	:	05/20/2010
Last Update Date	:	07/21/2022

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