Healthcare Provider Details

I. General information

NPI: 1093638686
Provider Name (Legal Business Name): HOLLAND BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 ROSE RIDGE RD
VERSAILLES KY
40383-9314
US

IV. Provider business mailing address

1029 ROSE RIDGE RD
VERSAILLES KY
40383-9314
US

V. Phone/Fax

Practice location:
  • Phone: 859-753-2597
  • Fax: 800-852-8917
Mailing address:
  • Phone: 859-753-2597
  • Fax: 800-852-8917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KELLY HOLLAND
Title or Position: OWNER
Credential: ANCC PMHNP, BLS
Phone: 859-753-2597