Provider Demographics
NPI:1992044143
Name:HOLLY HILL HOSPITAL MOBILE CRISIS
Entity Type:Organization
Organization Name:HOLLY HILL HOSPITAL MOBILE CRISIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MOBILE CRISIS COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:TIPPENS
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-431-0280
Mailing Address - Street 1:943 W ANDREWS AVE UNIT K
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536
Mailing Address - Country:US
Mailing Address - Phone:252-431-0280
Mailing Address - Fax:252-431-0284
Practice Address - Street 1:943 W ANDREWS AVE STE K
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2587
Practice Address - Country:US
Practice Address - Phone:252-431-0280
Practice Address - Fax:252-431-0284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLLY HILL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC283Q00000X283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital