# WHOLISTICALLY DIVINE

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

## Provider details

- **NPI number:** 1962235796
- **Authorized official:** ERICA GORDON CD (OWNER)
- **Authorized official phone:** (614) 381-1359

## Contact information

- **Practice address:** 185 HEFFRON CIR, MAINEVILLE, OH 45039-7342
- **Practice address phone:** (614) 381-1359
- **Mailing address:** 185 HEFFRON CIR, MAINEVILLE, OH 45039-7342
- **Mailing address phone:** (614) 381-1359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 261QB0400X | Birthing Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/26/2024
- **Last updated:** 09/11/2024