Holistic Behavioral Health Llc | |
101 Long Pass Ct Lake Saint Louis MO 63367-5051 | |
(314) 600-5221 | |
Not Available |
Full Name | Holistic Behavioral Health Llc |
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Speciality | Psychiatry & Neurology |
Location | 101 Long Pass Ct, Lake Saint Louis, Missouri |
Authorized Official Name and Position | Ornela Claude Ika (NURSE PRACTITIONER) |
Authorized Official Contact | 3146005221 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Holistic Behavioral Health Llc 101 Long Pass Ct Lake Saint Louis MO 63367-5051 Ph: (314) 600-5221 | Holistic Behavioral Health Llc 101 Long Pass Ct Lake Saint Louis MO 63367-5051 Ph: (314) 600-5221 |
NPI Number | 1457103103 |
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Provider Enumeration Date | 04/04/2024 |
Last Update Date | 04/04/2024 |
Certification Date | 04/04/2024 |
Medicare PECOS PAC ID | 1153865241 |
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Medicare Enrollment ID | O20240701000594 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457103103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Ornela Claude Ika |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477338291 PECOS PAC ID: 4284077116 Enrollment ID: I20240208000455 |
Provider Name | Manouchka Mildor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265211395 PECOS PAC ID: 3173064995 Enrollment ID: I20240920000600 |
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