Provider Demographics
NPI:1922454149
Name:WHOLE CARE, LLC
Entity Type:Organization
Organization Name:WHOLE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-229-2552
Mailing Address - Street 1:84 HIGHLAND AVE
Mailing Address - Street 2:STE 309
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2727
Mailing Address - Country:US
Mailing Address - Phone:978-354-5023
Mailing Address - Fax:978-560-0114
Practice Address - Street 1:84 HIGHLAND AVE
Practice Address - Street 2:STE 309
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2727
Practice Address - Country:US
Practice Address - Phone:978-354-5023
Practice Address - Fax:978-560-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246210261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center