Provider Demographics
NPI:1245122175
Name:HOLISTIC ADVANCEMENT
Entity type:Organization
Organization Name:HOLISTIC ADVANCEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:904-945-9975
Mailing Address - Street 1:909 BLANE LN
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2121
Mailing Address - Country:US
Mailing Address - Phone:904-945-9975
Mailing Address - Fax:
Practice Address - Street 1:909 BLANE LN
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2121
Practice Address - Country:US
Practice Address - Phone:904-945-9975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)