Organization
HOLLY CONVALESCENT CENTER, INC.
Active
Other names
Holly Convalescent Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID HANEY (AUTHORIZED OFFICIAL)
(248) 634-9281
Entity
Organization
Contact information
Practice address
313 SHERWOOD ST, HOLLY, MI 48442-1232
(248) 634-9281
(248) 634-9553
Mailing address
313 SHERWOOD ST, HOLLY, MI 48442-1232
(248) 634-9281
(248) 634-9553
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
63-4380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23E252
—
MI
01
—
63-4380
STATE FACILITY NUMBER
MI
Enumeration date
11/08/2006
Last updated
01/16/2015
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