MEDICARE: HOLISTIC HAVEN

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	:	1841591815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC HAVEN

Provider Business Mailing Address
First Line	:	2600 WESTHOLLOW DR
Second Line	:	APT 1721
City	:	HOUSTON
State	:	TX
Zip	:	77082-1912
Country	:	US
Telephone Number	:	832-230-9603
Fax Number	:	832-230-9603

Provider Business Practice Location Address
First Line	:	2600 WESTHOLLOW DR
Second Line	:	APT 1721
City	:	HOUSTON
State	:	TX
Zip	:	77082-1912
Country	:	US
Telephone Number	:	832-230-9603
Fax Number	:	832-230-9603

Authorized Official
Title or Position	:	LVN/OWNER/ADMINISTRATOR
Name	:	MS. BRITTNEY CHARLYCE SYKES
Credential	:
Telephone Number	:	832-230-9603

Provider Enumeration Date	:	11/08/2010
Last Update Date	:	11/08/2010

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Directions to “HOLISTIC HAVEN ” Practice Location

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