Wholistic Therapeutic Services

LBN: Wholistic Therapeutic Services
Wholistic Therapeutic Services is an health care organization with primary practice located at 911 Main St S , Tifton GA 31794-4867. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Wholistic Therapeutic Services can be contacted via phone (229) 396-4689, or through Tanner, Jamie V. via phone (229) 396-4689.

Contact Information

Primary practice address
911 Main St S Tifton GA 31794-4867
Phone: (229) 396-4689
Fax: (229) 396-4605
Website:
Map and Directions
Authorized official contact:
Name: Tanner, Jamie V.
Phone: (229) 396-4689

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1558971804
LBN Legal business name Wholistic Therapeutic Services
DBA Doing business as
Authorized official Tanner, Jamie V.
Entity Organization
Organization subpart 1 No
Enumeration date Aug 2nd, 2020
Last updated Aug 2nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558971804 NPPES
Georgia MEDICAID 003189286A

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