Provider Demographics
NPI:1932539533
Name:WHOLE HEALTH CONCORD LLC
Entity Type:Organization
Organization Name:WHOLE HEALTH CONCORD LLC
Other - Org Name:WHOLE HEALTH CONCORD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:603-369-4626
Mailing Address - Street 1:91 N STATE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4300
Mailing Address - Country:US
Mailing Address - Phone:603-369-4626
Mailing Address - Fax:603-369-4627
Practice Address - Street 1:91 N STATE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4300
Practice Address - Country:US
Practice Address - Phone:603-369-4626
Practice Address - Fax:603-369-4627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1486104100000X
NH51175F00000X
NH92175F00000X
NH91175F00000X
NH4045M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty