Healthcare Provider Details

I. General information

NPI: 1154257657
Provider Name (Legal Business Name): HOLLYWOOD HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 SW 29TH ST
TOPEKA KS
66611-1909
US

IV. Provider business mailing address

2222 SW 29TH ST
TOPEKA KS
66611-1909
US

V. Phone/Fax

Practice location:
  • Phone: 785-380-5400
  • Fax:
Mailing address:
  • Phone: 785-380-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: THATCHER HORAK
Title or Position: OWNER
Credential:
Phone: 785-260-1532