# HOLLY HILL HOUSE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699775189
- **Authorized official:** JOSEPH C TUTERA (MANAGER)
- **Authorized official phone:** (816) 444-0900

## Contact information

- **Practice address:** 100 KINGSTON RD, SULPHUR, LA 70663-4016
- **Practice address phone:** (337) 625-5843
- **Practice address fax:** (337) 625-3432
- **Mailing address:** 100 KINGSTON RD, SULPHUR, LA 70663-4016
- **Mailing address phone:** (337) 625-5843
- **Mailing address fax:** (337) 625-3432

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 198 | LA | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | 198 | LA | — |

## Other

- **Enumeration date:** 07/26/2005
- **Last updated:** 04/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1517038 | — | LA |