Provider Demographics
NPI:1841682648
Name:WHOLE HEALTH LLC
Entity type:Organization
Organization Name:WHOLE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SICLARE
Authorized Official - Suffix:
Authorized Official - Credentials:CNS
Authorized Official - Phone:203-994-2771
Mailing Address - Street 1:43 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5919
Mailing Address - Country:US
Mailing Address - Phone:203-431-3737
Mailing Address - Fax:203-431-3517
Practice Address - Street 1:43 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-5919
Practice Address - Country:US
Practice Address - Phone:203-431-3737
Practice Address - Fax:203-431-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCNS16122261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service