# HOLISTIC IN HOME SUPPORT SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194950329
- **Authorized official:** ALICIA MCKENZIE (OWNER)
- **Authorized official phone:** (904) 463-2510

## Contact information

- **Practice address:** 1013 ENON CT, ST AUGUSTINE, FL 32092-0431
- **Practice address phone:** (904) 463-2510
- **Practice address fax:** (904) 940-4795
- **Mailing address:** 1013 ENON CT, ST AUGUSTINE, FL 32092-0431
- **Mailing address phone:** (904) 463-2510
- **Mailing address fax:** (904) 940-4795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372600000X | Adult Companion | — | NULL | Yes |
| 372600000X | Adult Companion | — | — | Yes |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |

## Other

- **Enumeration date:** 05/18/2009
- **Last updated:** 01/11/2010