Provider Demographics
NPI:1447648894
Name:CENTER FOR HOLISTIC HEALING LLC
Entity type:Organization
Organization Name:CENTER FOR HOLISTIC HEALING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PYT
Authorized Official - Phone:502-762-3387
Mailing Address - Street 1:7225 E ORCHARD GRASS BLVD
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8561
Mailing Address - Country:US
Mailing Address - Phone:502-762-3387
Mailing Address - Fax:
Practice Address - Street 1:205 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:PEWEE VALLEY
Practice Address - State:KY
Practice Address - Zip Code:40056-9174
Practice Address - Country:US
Practice Address - Phone:502-290-0694
Practice Address - Fax:502-242-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty