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General NPI Number Information
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NPI Number | 1336689066
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Entity Type | Organization
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Legal Business Name | HOLLY'S HEART
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 147 N RED BUD TRL
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City | ELGIN
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State | TX
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Zip | 78621-5711
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Country | US
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Telephone | 512-297-3179
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Fax | 512-233-0724
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Provider Business Mailing Address
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Address Line | 147 N RED BUD TRL
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City | ELGIN
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State | TX
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Zip | 78621-5711
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Country | US
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Telephone | 512-297-3179
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Fax | 512-233-0724
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. CHRISTIE BELL SANDERS
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Credential |
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Telephone | 512-297-3179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | TX
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