Provider Demographics
NPI:1952910390
Name:THE WHOLE VILLAGE, LLC
Entity Type:Organization
Organization Name:THE WHOLE VILLAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ FOUNDER/ PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANIQUE
Authorized Official - Middle Name:G
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-371-9990
Mailing Address - Street 1:PO BOX 893292
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589-3292
Mailing Address - Country:US
Mailing Address - Phone:949-371-9990
Mailing Address - Fax:
Practice Address - Street 1:1968 S COAST HWY STE 1188
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3681
Practice Address - Country:US
Practice Address - Phone:949-371-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty