Organization
HOLLYDELL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACANNE H RYAN (EXECUTIVE DIRECTOR)
(856) 582-5151
Entity
Organization
Contact information
Practice address
11 PARKE PLACE BLVD, SEWELL, NJ 08080-2664
(856) 553-6642
(856) 553-6646
Mailing address
610 HOLLY DELL DR, SEWELL, NJ 08080-9120
(856) 582-5151
(856) 582-5055
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5151
—
NJ
Enumeration date
04/24/2013
Last updated
04/24/2013
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