Provider Demographics
NPI:1689469272
Name:HOLISTIC WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:HOLISTIC WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:QUACH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:650-275-3644
Mailing Address - Street 1:91-1063 PAAPAANA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5633
Mailing Address - Country:US
Mailing Address - Phone:650-271-3644
Mailing Address - Fax:
Practice Address - Street 1:91-1063 PAAPAANA ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5633
Practice Address - Country:US
Practice Address - Phone:650-271-3644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health