Organization Name: | WHOLISTIC HEALTH SERVICES |
NPI Number: | 1669883666 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEITH GILL (ADMINASTRATOR) |
Mailing Address: | 3514 Eagle Nest Dr Crete |
State: | IL US |
Postal Code: | 604171291 |
Phone Number: | 7083671299 |
Fax Number: | 7083671458 |
NPI Enumeration Date: | 05/13/2014 |
NPI Last Update Date: | 05/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |