Provider Demographics
NPI:1902438120
Name:WILLOW HOLISTIC WELLNESS
Entity Type:Organization
Organization Name:WILLOW HOLISTIC WELLNESS
Other - Org Name:WILLOW HOLISTIC WELLNESS NEVADA
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-949-3551
Mailing Address - Street 1:4040 ERIE ST PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094
Mailing Address - Country:US
Mailing Address - Phone:855-949-3551
Mailing Address - Fax:
Practice Address - Street 1:7455 ARROYO CROSSING PKWY STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4088
Practice Address - Country:US
Practice Address - Phone:855-949-3551
Practice Address - Fax:512-856-6228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLOW HOLISTIC WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-05
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty