Provider Demographics
NPI:1245873702
Name:WHOLE SELF CARE LLC
Entity type:Organization
Organization Name:WHOLE SELF CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REG.DIETITIAN/REG./YOGA TEACH
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MSRDLD RYT
Authorized Official - Phone:252-377-1881
Mailing Address - Street 1:2316 BRANDMOOR DR
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553
Mailing Address - Country:US
Mailing Address - Phone:252-377-1881
Mailing Address - Fax:769-235-1010
Practice Address - Street 1:6001 GRELOT RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609
Practice Address - Country:US
Practice Address - Phone:252-377-1881
Practice Address - Fax:769-235-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty