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BLACK WILLOW HOLISTIC CENTER LLC
NPI 1184490872
Religious Nonmedical Practitioner in Salem, IL

Active since December 04, 2023
301 OGLESBY ST, SALEM, IL 62881(618) 292-8518 Get Directions Write a Review

NPPES record last updated: December 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 12, 2023, Dec 4, 2023 (2 updates tracked since 2023).

About Black Willow Holistic Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK WILLOW HOLISTIC CENTER LLC (NPI 1184490872) is a healthcare organization registered as a religious nonmedical practitioner in Salem, Illinois and active in the NPI registry since December 2023. The organization lists Candice Ullery, Owner, as its authorized official.

NPPES Registry Identity

NPI1184490872
Entity TypeOrganization
Primary Taxonomy374K00000X
Legal Business NameBLACK WILLOW HOLISTIC CENTER LLC
Location Address301 OGLESBY STSalem, IL 62881-2724
Mailing Address301 Oglesby StSalem, IL 62881-2724 · (618) 292-8518
Phone(618) 292-8518
Organization SubpartNo
Authorized OfficialCandice UlleryOwner · (618) 292-8518
Enumeration DateDecember 4, 2023
Last NPPES UpdateDecember 12, 20232 updates tracked since enumeration
NPPES CertifiedDecember 12, 2023
✔ NPI 1184490872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyReligious Nonmedical PractitionerNursing Service Related Providers
Taxonomy Code374K00000X
Definition
A religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, or written correspondence.
301 OGLESBY ST, Salem, IL 62881
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black Willow Holistic Center LLC's NPI number?

The NPI number for Black Willow Holistic Center LLC is 1184490872. It was assigned to this organization in the NPPES registry on December 4, 2023.

Where is Black Willow Holistic Center LLC located?

Black Willow Holistic Center LLC is located at 301 Oglesby St, Salem, IL 62881. The listed phone number is (618) 292-8518.

What is Black Willow Holistic Center LLC's specialty?

The primary specialty registered for this NPI is Religious Nonmedical Practitioner with taxonomy code 374K00000X.

When was this NPI record last updated?

The NPPES record for Black Willow Holistic Center LLC was last updated on December 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.