Provider Demographics
NPI:1750860938
Name:WHOLE FAMILY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:WHOLE FAMILY HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-925-8200
Mailing Address - Street 1:827 18TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6481
Mailing Address - Country:US
Mailing Address - Phone:772-925-8190
Mailing Address - Fax:772-925-8199
Practice Address - Street 1:981 37TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6541
Practice Address - Country:US
Practice Address - Phone:772-257-5785
Practice Address - Fax:772-257-5325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHOLE FAMILY HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-09
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022558502Medicaid
FL251948802Medicaid
FL022558502Medicaid