Provider Type Icon

BLACK WILLOW HOLISTIC CENTER LLC NPI 1184490872


NPI Information

NPI: 1184490872
Provider Name: BLACK WILLOW HOLISTIC CENTER LLC
Classification: Religious Nonmedical Practitioner - 374K00000X
Entity Type: Organization
Address:
301 OGLESBY ST
SALEM, IL
ZIP 62881
Phone: (618) 292-8518
Get Directions

BLACK WILLOW HOLISTIC CENTER LLC is a religious nonmedical practitioner in Salem, IL. The provider is a religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, or written correspondence. BLACK WILLOW HOLISTIC CENTER LLC NPI is 1184490872. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

301 OGLESBY ST
SALEM, IL
ZIP 62881-724
Phone: (618) 292-8518

The provider's authorized official is Candice Ullery .
The authorized official title is Owner and has the following contact phone number (618) 292-8518.

The enumeration date for this NPI number is 12/4/2023 and was last updated on 12/12/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1374K00000XReligious Nonmedical PractitionerYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.