Provider Demographics
NPI:1396330007
Name:HOLLY HOMECARE LLC
Entity type:Organization
Organization Name:HOLLY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MWEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-708-2864
Mailing Address - Street 1:1001 E COTHRELL ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2984
Mailing Address - Country:US
Mailing Address - Phone:913-449-0012
Mailing Address - Fax:
Practice Address - Street 1:1001 E COTHRELL ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-2984
Practice Address - Country:US
Practice Address - Phone:913-449-0012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care