Organization
WHOLE LIFE HEALTH SUPPORT SERVICES
Active
Organization
WHOLE LIFE HEALTH SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JACKSON (CEO)
(702) 321-6222
Entity
Organization
Contact information
Practice address
2525 N DECATUR BLVD STE 2, LAS VEGAS, NV 89108-2976
(702) 321-6222
Mailing address
7124 DIVING PETRELS PL, N LAS VEGAS, NV 89084-2353
(702) 321-6222
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
20111426158
NV
Other
Enumeration date
06/15/2011
Last updated
05/26/2015
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