Organization
HOLYSTIC HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETRAND EKENJA DNP, CRNP (CEO)
(301) 683-8313
Entity
Organization
Contact information
Practice address
7375 EXECUTIVE PL STE 400 #1001, LANHAM, MD 20706-6232
(301) 683-8313
(859) 208-1326
Mailing address
7375 EXECUTIVE PL STE 400 #1001, LANHAM, MD 20706-6232
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/12/2024
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