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General NPI Number Information
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NPI Number | 1871300426
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Entity Type | Organization
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Legal Business Name | WHOLEHEARTED COMMUNITY SERVICES
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 3020 I ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-3841
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Country | US
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Telephone | 279-444-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 6722 FAIR OAKS BLVD STE 105
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City | CARMICHAEL
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State | CA
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Zip | 95608-3812
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Country | US
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Telephone | 916-765-6951
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | AVEN ARMSTRONG-SUTTON
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Credential | BSW, MSW, BCD
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Telephone | 279-444-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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