Provider Demographics
NPI:1922879352
Name:WHOLEHEALTH ENTERPRISES INC.
Entity Type:Organization
Organization Name:WHOLEHEALTH ENTERPRISES INC.
Other - Org Name:WHOLEHEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PERNELL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-528-8002
Mailing Address - Street 1:10866 WASHINGTON BLVD # 854
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 CONTINENTAL BLVD STE 600
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5074
Practice Address - Country:US
Practice Address - Phone:310-528-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered Meals