HOLISTIX OUTPATIENT CENTER NPI 1407226434

NPI Information

NPI: 1407226434
Provider Name: HOLISTIX OUTPATIENT CENTER
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 39D2111067

Address:
2300 S BROAD ST
STE 202-203
PHILADELPHIA, PA
ZIP 19145
Phone: (856) 889-0617
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HOLISTIX OUTPATIENT CENTER is a rehabilitation and substance use disorder clinic center in Philadelphia, PA. HOLISTIX OUTPATIENT CENTER NPI is 1407226434. The provider is registered as an organization entity type.

The provider's business location address is:

2300 S BROAD ST
STE 202-203
PHILADELPHIA, PA
ZIP 19145-461
Phone: (856) 889-0617

The provider's authorized official is Albert Coccia .
The authorized official title is Ceo and has the following contact phone number (856) 889-0617.

The CLIA number assigned to this NPI record is 39D2111067 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2015 and was last updated on 8/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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