Provider Demographics
NPI:1326427162
Name:HOLISTIC HEALER & WELLNESS CENTER INC
Entity type:Organization
Organization Name:HOLISTIC HEALER & WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRITION THERAPIST
Authorized Official - Phone:313-299-9800
Mailing Address - Street 1:3998 CLIPPERT ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-2731
Mailing Address - Country:US
Mailing Address - Phone:313-299-9800
Mailing Address - Fax:
Practice Address - Street 1:3998 CLIPPERT ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HTS
Practice Address - State:MI
Practice Address - Zip Code:48125-2731
Practice Address - Country:US
Practice Address - Phone:313-299-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health