Provider Demographics
NPI:1215196167
Name:WHOLISTIC RESOLVE AROUND PEOPLE SERVICES
Entity Type:Organization
Organization Name:WHOLISTIC RESOLVE AROUND PEOPLE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:443-463-6494
Mailing Address - Street 1:2408 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5102
Mailing Address - Country:US
Mailing Address - Phone:443-449-5487
Mailing Address - Fax:
Practice Address - Street 1:2408 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5102
Practice Address - Country:US
Practice Address - Phone:443-449-5487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402185100Medicaid