Provider Demographics
NPI:1861254153
Name:HOLISTIC COMMUNITY CARE, INC
Entity type:Organization
Organization Name:HOLISTIC COMMUNITY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PONI
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:615-479-1418
Mailing Address - Street 1:2201 MURFREESBORO PIKE BLDG C
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3327
Mailing Address - Country:US
Mailing Address - Phone:615-479-1418
Mailing Address - Fax:615-621-1221
Practice Address - Street 1:6429 PADDINGTON WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1150
Practice Address - Country:US
Practice Address - Phone:615-479-1418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care