Organization
HOLLY HILL HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH C TUTERA (MANAGER)
(816) 444-0900
Entity
Organization
Contact information
Practice address
100 KINGSTON RD, SULPHUR, LA 70663-4016
(337) 625-5843
(337) 625-3432
Mailing address
100 KINGSTON RD, SULPHUR, LA 70663-4016
(337) 625-5843
(337) 625-3432
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
198
LA
335E00000X
Prosthetic/Orthotic Supplier
198
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517038
—
LA
Enumeration date
07/26/2005
Last updated
04/19/2024
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