Provider Demographics
NPI:1245504042
Name:HOLLAND INITIATIVE, INC.
Entity type:Organization
Organization Name:HOLLAND INITIATIVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-510-6507
Mailing Address - Street 1:2951 RED BANKS RD N
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-7982
Mailing Address - Country:US
Mailing Address - Phone:662-510-6507
Mailing Address - Fax:662-510-6508
Practice Address - Street 1:5779 GETWELL RD
Practice Address - Street 2:BLDG. D, SUITE 3
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-6347
Practice Address - Country:US
Practice Address - Phone:662-510-6507
Practice Address - Fax:662-510-6508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty