Healthcare Provider Details

I. General information

NPI: 1790785608
Provider Name (Legal Business Name): HOLLY HEIGHTS NURSING HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 E ILIFF AVE
DENVER CO
80222-5721
US

IV. Provider business mailing address

6000 E ILIFF AVE
DENVER CO
80222-5721
US

V. Phone/Fax

Practice location:
  • Phone: 303-757-5441
  • Fax: 303-757-8862
Mailing address:
  • Phone: 303-757-5441
  • Fax: 303-757-8862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0439
License Number StateCO

VIII. Authorized Official

Name: MS. JANET L SNIPES
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 303-757-5441