Panache Holistics

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

PANACHE HOLISTICS

Practice address

2552 Barcelona Ave
Fort Myers, FL 33905-2212

Phone

(239) 410-6250

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Mary E Provencher

Title

President, Ceo

Phone

(239) 839-4997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1376296301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 BARCELONA AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339052212",
            "telephone_number": "239-410-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 BARCELONA AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339052212",
            "telephone_number": "239-410-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACHE HOLISTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "PROVENCHER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "239-839-4997"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Palmon, M.D.
• Sally Palmon, M.D.
• Pamela a. Denson LMT Inc.
• Sunil Pammi, MD
• Panaceas Therapy Care, LLC
• Veska Pandika, MD
• Tammy L Pangburn
• Monserrat Paniagua
• Dena Paniccia, LCSW
• Veronica Gennadievna Papavero, M.D.

• Assisted Living Facility (Behavioral Disturbances) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Assisted Living Facility (Behavioral Disturbances) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.