Provider Demographics
NPI:1962191668
Name:WHOLEHEARTED CONNECTIONS PLC
Entity type:Organization
Organization Name:WHOLEHEARTED CONNECTIONS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BREANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW
Authorized Official - Phone:563-949-1114
Mailing Address - Street 1:703 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:IL
Mailing Address - Zip Code:61230-9630
Mailing Address - Country:US
Mailing Address - Phone:563-949-1114
Mailing Address - Fax:
Practice Address - Street 1:3475 JERSEY RIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2293
Practice Address - Country:US
Practice Address - Phone:563-362-2815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)