NPIMap

Organization Active NPI

Hollydell, Inc.

  • In Home Supportive Care Agency
  • Sewell, NJ
National Provider Identifier
1134563505
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HOLLYDELL, INC.
Practice address
610 Holly Dell Dr
Sewell, NJ 08080-9120
Phone
(856) 582-5151
Fax
(856) 582-5055
NPI assigned
Apr 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Gracanne H Ryan
Title
Executive Director
Phone
(856) 582-5151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

610 Holly Dell Dr
Sewell, NJ 08080-9120

Mailing address

610 Holly Dell Dr
Sewell, NJ 08080-9120
Phone (856) 582-5151

Other identifiers 1

IdentifierTypeStateIssuer
5151MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Hollydell Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1134563505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HOLLY DELL DR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809120",
            "telephone_number": "856-582-5151",
            "fax_number": "856-582-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 HOLLY DELL DR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809120",
            "telephone_number": "856-582-5151",
            "fax_number": "856-582-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYDELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "GRACANNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-582-5151"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5151",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.