Provider Demographics
NPI:1790501583
Name:FIRST WHOLISTIC HEALTHCARE PROVIDERS LLC
Entity type:Organization
Organization Name:FIRST WHOLISTIC HEALTHCARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMOABEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-465-6444
Mailing Address - Street 1:6154 TEAGARDEN CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6154 TEAGARDEN CIR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449-3014
Practice Address - Country:US
Practice Address - Phone:513-224-8102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty