South Holland Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2208602 Issued in IL

Legal business name

SOUTH HOLLAND HOME, LLC

Doing business as

Holland Home

Practice address

16300 Louis Ave
South Holland, IL 60473-2281

Phone

(708) 596-3050

NPI assigned

May 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Benjamin Israel

Title

Manager

Phone

(847) 440-2660

Specialties & licenses 1

Addresses

Other names 1

• Holland Home Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1053768150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 CHASE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764008",
            "telephone_number": "847-440-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 LOUIS AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732281",
            "telephone_number": "708-596-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HOLLAND HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-440-2660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "2208602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holland Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lolita Smith, M.D.
• Nyree Smith, RN
• Robert E Smith
• Sheree L Sneed
• Brittaney Solomon
• South Holland Manor HRC LLC
• South Holland Physical Therapy & Rehabilitation, LTD.
• South Holland School District - 151
• South Loop Counseling Services, LLC
• South Park Dental Care

• Assisted Living Facility in South Holland, IL
• Providers in South Holland, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.