Provider Demographics
NPI:1083285092
Name:WHOLENESS HOME HEALTH LLC
Entity Type:Organization
Organization Name:WHOLENESS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:LAUREN PATRICE
Authorized Official - Last Name:O'HANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-212-2384
Mailing Address - Street 1:1925 E PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1517
Mailing Address - Country:US
Mailing Address - Phone:856-212-2384
Mailing Address - Fax:
Practice Address - Street 1:2122 E CHELTEN AVE FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2536
Practice Address - Country:US
Practice Address - Phone:856-212-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health