Organization
HOLON HEALTH GREAT LAKES, P.C.
Active
Other names
Holon Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON HERZOG (CEO)
(877) 754-4694
Entity
Organization
Contact information
Practice address
11551 NUCKOLS RD STE R, GLEN ALLEN, VA 23059-5565
(877) 465-6650
(804) 294-2775
Mailing address
3540 PUMP RD # 1188, RICHMOND, VA 23233-1115
(877) 754-4694
(804) 294-2775
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/08/2023
Last updated
03/18/2026
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