Healthcare Provider Details

I. General information

NPI: 1831004183
Provider Name (Legal Business Name): WHOLE LIFE INTEGRATED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 S JONES BLVD STE 106
LAS VEGAS NV
89146-6768
US

IV. Provider business mailing address

3275 S JONES BLVD STE 106
LAS VEGAS NV
89146-6768
US

V. Phone/Fax

Practice location:
  • Phone: 702-822-0584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC DAVIS II
Title or Position: MANAGAING MEMBER
Credential:
Phone: 702-822-0584