# SOUTHERN OREGON HOLISTIC WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1326999699
- **Authorized official:** PHILIP ABRAHAM LEVENSON (CEO)
- **Authorized official phone:** (808) 777-0250

## Contact information

- **Practice address:** 213 SW 4TH ST, GRANTS PASS, OR 97526-2407
- **Practice address phone:** (541) 761-1487
- **Mailing address:** 3685 WINDY CREEK RD, GLENDALE, OR 97442-9786
- **Mailing address phone:** (808) 777-0250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/04/2026
- **Last updated:** 02/04/2026