Organization
BLACK WILLOW HOLISTIC CENTER LLC
Active
Organization
BLACK WILLOW HOLISTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE ULLERY SBD (OWNER)
(618) 292-8518
Entity
Organization
Contact information
Practice address
301 OGLESBY ST, SALEM, IL 62881-2724
(618) 292-8518
Mailing address
301 OGLESBY ST, SALEM, IL 62881-2724
(618) 292-8518
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/12/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up