Manifest Holistic Centre, LLC

Key facts

NPI

1497516462

Entity type

Organization (NPI type 2)

Primary specialty

Health & Wellness Coach 171400000X

Legal business name

MANIFEST HOLISTIC CENTRE, LLC

Practice address

17800 Chillicothe Rd Ste 240
Chagrin Falls, OH 44023-4886

Phone

(440) 384-3196

NPI assigned

Jan 17, 2024

Organization subpart

No

Authorized official

Name

Keira Sealie

Title

Office Administrator

Phone

(360) 209-3440

Practitioners 1

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

• Davvie Moore Doula · Chagrin Falls, OH · NPI 1447079926
  NPD DOULA

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 17, 2024.

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1497516462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 CHILLICOTHE RD STE 240",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234886",
            "telephone_number": "440-384-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 CHILLICOTHE RD STE 240",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234886",
            "telephone_number": "440-384-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIFEST HOLISTIC CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "SEALIE",
        "authorized_official_first_name": "KEIRA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-209-3440"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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