Provider Demographics
NPI:1205133402
Name:WHOLE SENIOR CARE LLC
Entity type:Organization
Organization Name:WHOLE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JAYMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SITTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:267-997-8866
Mailing Address - Street 1:306 HENRY LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6412
Mailing Address - Country:US
Mailing Address - Phone:267-997-8866
Mailing Address - Fax:833-315-2198
Practice Address - Street 1:306 HENRY LN
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6412
Practice Address - Country:US
Practice Address - Phone:267-997-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X
PACW016886253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA803254OtherMEDICARE