Organization
HOLISTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI PELOSI APRN (OWNER)
(203) 525-8052
Entity
Organization
Contact information
Practice address
969 W MAIN ST, 1 D, WATERBURY, CT 06708-2653
(203) 525-8052
Mailing address
969 W MAIN ST STE 1D, WATERBURY, CT 06708-2667
(203) 465-6537
(203) 758-1594
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
005149
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
005149
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008057481
—
CT
Enumeration date
01/23/2015
Last updated
09/10/2015
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