Provider Demographics
NPI:1376300681
Name:WHOLE WELLNESS HOMECARE LLC.
Entity Type:Organization
Organization Name:WHOLE WELLNESS HOMECARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAKEEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-932-0256
Mailing Address - Street 1:3224 CARR DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3333
Mailing Address - Country:US
Mailing Address - Phone:313-932-0256
Mailing Address - Fax:
Practice Address - Street 1:3224 CARR DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3333
Practice Address - Country:US
Practice Address - Phone:313-932-0256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health