Holly Park Family Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

HOLLY PARK FAMILY HOME

Practice address

321 Holly Park Circle
San Francisco, CA 94110

Phone

(415) 648-8292

Fax

(415) 648-8292

NPI assigned

Sep 13, 2007

Last updated

Jul 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Conchita Rabara Berry

Title

Adm and Licensee

Phone

(415) 648-8292

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1528253465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 HOLLY PARK CIRCLE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "415-648-8292",
            "fax_number": "415-648-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 HOLLY PARK CIRCLE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "415-648-8292",
            "fax_number": "415-648-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY PARK FAMILY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "CONCHITA",
        "authorized_official_middle_name": "RABARA",
        "authorized_official_title_or_position": "ADM AND LICENSEE",
        "authorized_official_telephone_number": "415-648-8292",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan David Holloway, PHD
• John Holloway, DO
• Kacee Holloway, BSW, MSW, ASW
• Kristina Anne Holloway, LMFT#152030
• Rachel Ann Holloway
• Lillian Holm, CRNA
• Ginger Marie Holman, L.C.S.W.
• Madison Oliver Holman
• Melissa Lynn Holman, LMFT
• Michael George Holman Jr., MD

• Mental Illness Community Based Residential Treatment Facility in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.