Provider Demographics
NPI:1447456140
Name:HOLISTIC HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:HOLISTIC HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PORSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-291-5038
Mailing Address - Street 1:13011 JUSTICE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-5330
Mailing Address - Country:US
Mailing Address - Phone:225-291-5038
Mailing Address - Fax:225-291-2534
Practice Address - Street 1:13011 JUSTICE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5330
Practice Address - Country:US
Practice Address - Phone:225-291-5038
Practice Address - Fax:225-291-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 12825315P00000X
LASIL 12826315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1470414Medicaid
LA1476587Medicaid
LA1476579Medicaid