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NPI Code Detail

MEDICARE: HOLLY HILL MANOR INC.

MEDICARE: HOLLY HILL MANOR INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility03016MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265436810
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLLY HILL MANOR INC.
Provider Business Mailing Address
First Line : 531 STEVENSON LN
Second Line :
City : TOWSON
State : MD
Zip : 21286-7607
Country : US
Telephone Number : 410-823-5310
Fax Number : 410-583-8148
Provider Business Practice Location Address
First Line : 531 STEVENSON LN
Second Line :
City : TOWSON
State : MD
Zip : 21286-7607
Country : US
Telephone Number : 410-823-5310
Fax Number : 410-583-8148
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. MILLARD L. CURSEY JR.
Credential :
Telephone Number : 410-823-5310
Provider Enumeration Date : 06/10/2005
Last Update Date : 04/24/2008

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Directions to “HOLLY HILL MANOR INC. ” Practice Location

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