Healthcare Provider Details
I. General information
NPI: 1952005951
Provider Name (Legal Business Name): THE WHOLE SPECTRUM CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2023
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
194 NEWARK AVE FL 2
JERSEY CITY NJ
07302-2725
US
IV. Provider business mailing address
344 GROVE ST PMB 15
JERSEY CITY NJ
07302
US
V. Phone/Fax
- Phone: 551-343-6031
- Fax:
- Phone: 551-343-6031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2050X |
| Taxonomy | Respite Care Camp |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2055X |
| Taxonomy | Child Mental Illness Respite Care |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERRY
SINGH
Title or Position: CEO
Credential:
Phone: 862-215-2570