Provider Demographics
NPI:1871300426
Name:WHOLEHEARTED COMMUNITY SERVICES
Entity type:Organization
Organization Name:WHOLEHEARTED COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG-SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, MSW, BCD
Authorized Official - Phone:279-444-2146
Mailing Address - Street 1:6722 FAIR OAKS BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3812
Mailing Address - Country:US
Mailing Address - Phone:916-765-6951
Mailing Address - Fax:
Practice Address - Street 1:3020 I ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3841
Practice Address - Country:US
Practice Address - Phone:279-444-2146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty