Provider Demographics
NPI:1053295766
Name:TAINO WHOLELIFE HEALTHCARE, LLC
Entity type:Organization
Organization Name:TAINO WHOLELIFE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SASCHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CNM
Authorized Official - Phone:917-653-6635
Mailing Address - Street 1:9 SILO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2507
Mailing Address - Country:US
Mailing Address - Phone:917-653-6635
Mailing Address - Fax:
Practice Address - Street 1:113 BARREN SPOT MALL
Practice Address - Street 2:SUITE 9
Practice Address - City:ST. CROIX
Practice Address - State:VI
Practice Address - Zip Code:00850
Practice Address - Country:US
Practice Address - Phone:917-653-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1568500734Medicaid