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General NPI Number Information
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NPI Number | 1073840575
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Entity Type | Organization
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Legal Business Name | HOLLY'S HOMES, L.L.C.
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 1956 TURNPIKE RD
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City | ALBERTVILLE
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State | AL
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Zip | 35950-4325
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Country | US
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Telephone | 256-894-5628
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Fax | 256-894-5628
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Provider Business Mailing Address
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Address Line | PO BOX 44
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-0044
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Country | US
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Telephone | 256-486-1330
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Fax | 256-894-5628
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Authorized Official
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Title or Position | OWNER / EXECUTIVE DIRECTOR
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Name | MS. RITA PENNINGTON
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Credential | REGISTERED NURSE
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Telephone | 256-483-1543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AL
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