OrganizationActive
Black Willow Holistic Center LLC
NPI 1184490872 · Religious Nonmedical Practitioner · Salem, IL
Provider details
- NPI number
- 1184490872
- Entity type
- Organization
- Primary specialty
- Religious Nonmedical PractitionerNursing Service Related Providers
- Authorized official
- Candice Ullery, Owner
Mailing address
301 Oglesby St
Salem, IL 62881-2724
Registry dates
- Enumerated
- 2023-12-04
- Last updated
- 2023-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.