Organization
HOLLY RIDGE HEALTHCARE, INC
Active
Organization
HOLLY RIDGE HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M. SELLS (PRESIDENT)
(636) 536-5365
Entity
Organization
Contact information
Practice address
13134 HIGHWAY 25, DEXTER, MO 63841-9740
(573) 624-4433
Mailing address
17826 EDISON AVE, CHESTERFIELD, MO 63005-1262
(636) 536-5365
(636) 536-4533
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518283381
—
MO
Enumeration date
04/19/2010
Last updated
11/08/2013
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