Provider Demographics
NPI:1912376088
Name:WHOLE LIFE RECOVERY
Entity Type:Organization
Organization Name:WHOLE LIFE RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-289-7900
Mailing Address - Street 1:3200 S CONGRESS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-9041
Mailing Address - Country:US
Mailing Address - Phone:561-289-7900
Mailing Address - Fax:
Practice Address - Street 1:3200 S CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-9041
Practice Address - Country:US
Practice Address - Phone:561-289-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder