Organization
HOLLIS MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NELA J HOLLIS LPC, NCC (OWNER)
(208) 452-7190
Entity
Organization
Contact information
Practice address
620 S IDAHO AVE, FRUITLAND, ID 83619-2607
(208) 452-7190
(208) 452-5819
Mailing address
620 S IDAHO AVE, FRUITLAND, ID 83619-2607
(208) 452-7190
(208) 452-5819
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
PSY202138
ID
251S00000X
Community/Behavioral Health Agency
Primary
PSY202138
ID
Other
Enumeration date
07/13/2009
Last updated
01/24/2011
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