1740517226 NPI number — HOLISTIC HUMAN SERVICES, INC.

Table of content: (NPI 1740517226)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740517226 NPI number — HOLISTIC HUMAN SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLISTIC HUMAN SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740517226
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 671
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARRBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27510-0671
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-582-0224
Provider Business Mailing Address Fax Number:
888-580-6555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4310 REGENCY DR STE 100, 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27265-9487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-582-0224
Provider Business Practice Location Address Fax Number:
888-982-6555
Provider Enumeration Date:
11/04/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GREEN
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PROGRAM EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
888-582-0224

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 5084 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 1581 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 1449 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8302895G , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302895H , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302895S , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302308 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3418975 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302895Q , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302895B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302895 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com