Holistic Homecare Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

HOLISTIC HOMECARE SERVICES LLC

Practice address

1156 Main St
Suite 2R
Brockton, MA 02301

Phone

(978) 995-2533

NPI assigned

Apr 1, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mabel Yatta JohnsonNPI 1275093460

Title

Administrator

Phone

(978) 995-2533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Home health agency certification: CCN 227675

Legal name

HOLISTIC HOMECARE SERVICES LLC

Doing business as

HOLISTIC HOME CARE SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 30, 2016

Last certification

Mar 30, 2016

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Mar 17, 2014 in MA

Enrollment address

505 Nashua Rd
Ste 12B
Dracut, MA 01826-1929
HHA Branch

Listed as

Holistic Home Care ServicesCCN 227675

Ownership

Proprietary

Certified

Mar 30, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mabel Yatta Johnson, NP

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Lowell, MA
  • NPI 1275093460

  5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mabel Yatta Johnson, NP

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Lowell, MA
  • NPI 1275093460
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1073931606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 MAIN ST STE 2R",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016833",
            "telephone_number": "978-995-2533",
            "fax_number": "978-649-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 MAIN ST",
            "address_2": "SUITE 2R",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "978-995-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HOMECARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MABEL",
        "authorized_official_middle_name": "YATTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "978-995-2533"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna D Hohler, MD
• Krista Hojlo, MSW, LCSW
• Daxius Hoke
• Robin Dawn Holcomb, MA CCC SLP
• Harriet Yvette Holder
• Matilda Holland
• Katherine Elizabeth Holleran, LICSW
• Damean Kristopher Hollis
• Norris Hollis
• Brenna Holmes-Mumford

• Home Health Agency in Brockton, MA
• Providers in Brockton, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.