Provider Demographics
NPI:1336689066
Name:HOLLY'S HEART
Entity Type:Organization
Organization Name:HOLLY'S HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-297-3179
Mailing Address - Street 1:147 N RED BUD TRL
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-5711
Mailing Address - Country:US
Mailing Address - Phone:512-297-3179
Mailing Address - Fax:512-233-0724
Practice Address - Street 1:147 N RED BUD TRL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-5711
Practice Address - Country:US
Practice Address - Phone:512-297-3179
Practice Address - Fax:512-233-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle