Organization
A HOLLYHOME ALF, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLY LYNNE DICKSON RN (OWNER)
(772) 807-9438
Entity
Organization
Contact information
Practice address
5288 NW NORTH MACEDO BLVD, PORT SAINT LUCIE, FL 34983-1464
(772) 807-9438
Mailing address
5288 NW NORTH MACEDO BLVD, PORT SAINT LUCIE, FL 34983-1464
(772) 807-9438
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10818
FL
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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