NPI 1215744198
Holistic Individual Support Living LLC
Practice location
- Address
- 529 Aurora Ave, Jefferson City, MO 65101-2816
- Phone
- (202) 518-7073
Authorised official
- Name
- Jovin M Bayingana
- Title
- Ceo
- Phone
- (207) 518-7073
Registered specialties
Mental Illness Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1215744198
- Entity type
- Organization
- NPI issued
- 14 Dec 2024
- Record last updated
- 30 Dec 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.