# HOLISTIQUE HOME CARE CORPORATION

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

## Provider details

- **NPI number:** 1215682927
- **Authorized official:** EVAH WANGUNGU (CEO)
- **Authorized official phone:** (660) 238-0262

## Contact information

- **Practice address:** 123 SPANISH OAK WAY \# 2, DALLAS, GA 30132-0862
- **Practice address phone:** (660) 238-0262
- **Mailing address:** 123 SPANISH OAK WAY, DALLAS, GA 30132-0862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2022
- **Last updated:** 02/21/2022