Provider Demographics
NPI:1902266166
Name:HOLISTIC NURSING & HEALTHCARE SERVICES LLC.
Entity Type:Organization
Organization Name:HOLISTIC NURSING & HEALTHCARE SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:HAJA
Authorized Official - Middle Name:FATIMA B
Authorized Official - Last Name:YAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN CMDN
Authorized Official - Phone:443-794-4444
Mailing Address - Street 1:5250 HARVEY LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6857
Mailing Address - Country:US
Mailing Address - Phone:443-794-4444
Mailing Address - Fax:410-802-4470
Practice Address - Street 1:5250 HARVEY LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6857
Practice Address - Country:US
Practice Address - Phone:443-794-4444
Practice Address - Fax:410-802-4470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3712251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54239491-00Medicaid