Provider Demographics
NPI:1447381256
Name:WHOLISTIC SERVICES, INC.
Entity Type:Organization
Organization Name:WHOLISTIC SERVICES, INC.
Other - Org Name:WHOLISTIC SERVICES, III
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIATTA
Authorized Official - Middle Name:N
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:ATTORNEY
Authorized Official - Phone:202-347-5334
Mailing Address - Street 1:2309 VARNUM ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1459
Mailing Address - Country:US
Mailing Address - Phone:202-832-8787
Mailing Address - Fax:202-347-1916
Practice Address - Street 1:1814 BUNKER HILL RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3220
Practice Address - Country:US
Practice Address - Phone:202-635-9321
Practice Address - Fax:202-636-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
315P00000X
DC025357300320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities