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General NPI Number Information
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NPI Number | 1841184371
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Entity Type | Organization
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Legal Business Name | WILLOWS HOLDINGS LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 9150 E 109TH AVE STE 3A
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City | CROWN POINT
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State | IN
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Zip | 46307-7686
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Country | US
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Telephone | 219-332-5101
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Fax | 219-332-5103
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Provider Business Mailing Address
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Address Line | 9150 E 109TH AVE STE 3A
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City | CROWN POINT
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State | IN
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Zip | 46307-7686
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Country | US
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Telephone | 219-332-5101
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Fax | 219-332-5103
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Authorized Official
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Title or Position | CEO
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Name | MARYANN BURK
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Credential | RN
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Telephone | 219-743-4365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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