MEDICARE: THE HOLLIS HOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1649075094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HOLLIS HOUSE

Provider Business Mailing Address
First Line	:	1547 FRONT ST
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-1175
Country	:	US
Telephone Number	:	732-439-0974
Fax Number	:

Provider Business Practice Location Address
First Line	:	1547 FRONT ST
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-1175
Country	:	US
Telephone Number	:	732-439-0974
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	D'ANDRE HOLLIS
Credential	:
Telephone Number	:	732-439-0974

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/18/2025

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Directions to “THE HOLLIS HOUSE ” Practice Location

Language	Start Address	Practice Location

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