Healthcare Provider Details

I. General information

NPI: 1760391684
Provider Name (Legal Business Name): THE WHOLE ME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 ROSY BILLED DR APT 306
CHARLOTTE NC
28262-1488
US

IV. Provider business mailing address

2515 ROSY BILLED DR APT 306
CHARLOTTE NC
28262-1488
US

V. Phone/Fax

Practice location:
  • Phone: 585-237-8880
  • Fax:
Mailing address:
  • Phone: 585-237-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY BURTON
Title or Position: CEO
Credential:
Phone: 585-237-8880