=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235359670
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE HOLY FAMILY FOUNDATION, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1648 S OHIO ST # 317
-----------------------------------------------------
City | SALINA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67401-6360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-827-6912
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1648 S OHIO ST # 317
-----------------------------------------------------
City | SALINA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67401-6360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-827-6912
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. TAMMI K. VAUGHN
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 785-827-6912
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 0054774-007
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------