Provider Demographics
NPI:1477959351
Name:WHOLE KIDS, LLC
Entity Type:Organization
Organization Name:WHOLE KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCSP, BCBA
Authorized Official - Phone:973-932-9086
Mailing Address - Street 1:34 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9160
Mailing Address - Country:US
Mailing Address - Phone:973-610-2606
Mailing Address - Fax:
Practice Address - Street 1:34 VALLEY RD
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-9160
Practice Address - Country:US
Practice Address - Phone:973-610-2606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11210493251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health