Provider Demographics
NPI:1942600986
Name:WHOLISTIC SERVICES, INC.
Entity Type:Organization
Organization Name:WHOLISTIC SERVICES, INC.
Other - Org Name:WHOLISTIC SERVICES, I
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-347-5334
Mailing Address - Street 1:680 RHODE ISLAND AVE NE
Mailing Address - Street 2:SUITE G1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1269
Mailing Address - Country:US
Mailing Address - Phone:202-832-8787
Mailing Address - Fax:202-832-1192
Practice Address - Street 1:4141 ANACOSTIA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1927
Practice Address - Country:US
Practice Address - Phone:202-347-5334
Practice Address - Fax:202-347-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities