Provider Demographics
NPI:1083301675
Name:HOLISTIC CARE MENTAL HEALTH ASSOCIATION LLC
Entity type:Organization
Organization Name:HOLISTIC CARE MENTAL HEALTH ASSOCIATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMBA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:413-306-8605
Mailing Address - Street 1:221B WOLLASTON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 UNION ST STE 42
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3485
Practice Address - Country:US
Practice Address - Phone:413-930-4562
Practice Address - Fax:413-707-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty