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General NPI Number Information
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NPI Number | 1790582930
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Entity Type | Organization
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Legal Business Name | HOLLY HOMECARE SERVICES INC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 3034 W GLEN HOLLY DR
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City | ANAHEIM
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State | CA
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Zip | 92804-3813
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Country | US
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Telephone | 310-408-5620
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Fax |
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Provider Business Mailing Address
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Address Line | 4122 MANZANITA
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City | IRVINE
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State | CA
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Zip | 92604-2709
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Country | US
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Telephone | 310-408-5620
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | IMELDA LENZ
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Credential | BS ACCOUNTANCY
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Telephone | 310-408-5620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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