Provider Demographics
NPI:1588274435
Name:HOLISTICARE BEHAVIORAL HEALTH SVS LLC
Entity type:Organization
Organization Name:HOLISTICARE BEHAVIORAL HEALTH SVS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAGANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-386-6899
Mailing Address - Street 1:8101 HINSON FARM RD STE 214
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3406
Mailing Address - Country:US
Mailing Address - Phone:703-360-6910
Mailing Address - Fax:
Practice Address - Street 1:8101 HINSON FARM RD STE 214
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3406
Practice Address - Country:US
Practice Address - Phone:703-386-6899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty