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General NPI Number Information
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NPI Number | 1407851785
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Entity Type | Organization
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Legal Business Name | HOLLY HILL RHF HOUSING, INC
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 900 LPGA BLVD
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City | HOLLY HILL
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State | FL
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Zip | 32117-3113
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Country | US
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Telephone | 386-226-9000
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Fax | 386-257-5069
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Provider Business Mailing Address
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Address Line | 900 LPGA BLVD
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City | HOLLY HILL
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State | FL
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Zip | 32117-3113
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Country | US
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Telephone | 386-226-9000
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Fax | 386-257-5069
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Authorized Official
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Title or Position | V.P. OF OPERATIONS
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Name | STUART HARTMAN
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Credential |
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Telephone | 562-257-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1052096
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License Number State | FL
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