Provider Demographics
NPI:1174578462
Name:WHOLISTIC HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:WHOLISTIC HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-947-8117
Mailing Address - Street 1:1724 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1913
Mailing Address - Country:US
Mailing Address - Phone:773-947-8117
Mailing Address - Fax:773-947-8599
Practice Address - Street 1:12201 WESTERN AVE STE 12
Practice Address - Street 2:
Practice Address - City:BLUE ISLAND
Practice Address - State:IL
Practice Address - Zip Code:60406-1363
Practice Address - Country:US
Practice Address - Phone:773-947-8117
Practice Address - Fax:773-947-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness