NPIMap

Organization Active NPI

Wholeness Lifestyle Services, LLC

  • Developmental Disabilities Clinic/Center
  • Upper Marlboro, MD
National Provider Identifier
1861253775
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
WHOLENESS LIFESTYLE SERVICES, LLC
Practice address
4310 Reverend Eversfield CT
Upper Marlboro, MD 20772-2917
Phone
(240) 779-5380
NPI assigned
Jan 18, 2024
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Cyril Chukwuemeka OkoroNPI 1831519933
Title
Ceo
Phone
(240) 779-5380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Home Health Agency 251E00000X NU
Adult Day Care Clinic/Center 261QA0600X NU
Developmental Disabilities Clinic/Center 261QD1600X NU Primary
Assisted Living Facility 310400000X NU
Assisted Living Facility (Mental Illness) 3104A0625X NU
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X NU
In Home Supportive Care Agency 253Z00000X NU

Addresses

Primary practice location

4310 Reverend Eversfield CT
Upper Marlboro, MD 20772-2917

Mailing address

4310 Reverend Eversfield CT
Upper Marlboro, MD 20772-2917
Phone (240) 779-5380

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1861253775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 REVEREND EVERSFIELD CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722917",
            "telephone_number": "240-779-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 REVEREND EVERSFIELD CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722917",
            "telephone_number": "240-779-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLENESS LIFESTYLE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "OKORO",
        "authorized_official_first_name": "CYRIL",
        "authorized_official_middle_name": "CHUKWUEMEKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-779-5380",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.