# WHOLISTIC RECOVERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093485336
- **Authorized official:** MS. LUCIA CAROL MATTHEW CPC-INTERN (THERAPIST)
- **Authorized official phone:** (707) 981-0289

## Contact information

- **Practice address:** 2580 N RANCHO DR STE 105, LAS VEGAS, NV 89130-3361
- **Practice address phone:** (702) 981-0289
- **Mailing address:** 2580 N RANCHO DR STE 105, LAS VEGAS, NV 89130-3361
- **Mailing address phone:** (702) 981-0289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2021
- **Last updated:** 09/17/2021