Provider Demographics
NPI:1649732553
Name:HOLISTIC HOME HEALTH AGENCY INC
Entity type:Organization
Organization Name:HOLISTIC HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISSET
Authorized Official - Suffix:I
Authorized Official - Credentials:LPN
Authorized Official - Phone:617-230-2922
Mailing Address - Street 1:859 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7482
Mailing Address - Country:US
Mailing Address - Phone:617-230-2922
Mailing Address - Fax:800-985-5354
Practice Address - Street 1:859 WILLARD ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7482
Practice Address - Country:US
Practice Address - Phone:617-230-2922
Practice Address - Fax:800-985-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MATK70OtherHOME HEALTH AGENCY