Provider Demographics
NPI:1659958585
Name:WHOLENESS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:WHOLENESS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-606-0055
Mailing Address - Street 1:8943 E DELAWARE PKWY
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3204
Mailing Address - Country:US
Mailing Address - Phone:708-606-0055
Mailing Address - Fax:708-249-0455
Practice Address - Street 1:8943 E DELAWARE PKWY
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3204
Practice Address - Country:US
Practice Address - Phone:708-606-0055
Practice Address - Fax:708-249-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty