NPIMap

Organization Active NPI

Hollydell, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Sewell, NJ
National Provider Identifier
1639513336
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
HOLLYDELL, INC.
Practice address
11 Parke Place Blvd
Sewell, NJ 08080-2664
Phone
(856) 553-6642
Fax
(856) 553-6646
NPI assigned
Apr 24, 2013
Last updated
Apr 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 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
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

11 Parke Place Blvd
Sewell, NJ 08080-2664

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.

Locations

11 Parke Place Blvd
Sewell, NJ 08080
Phone (856) 553-6642

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1639513336",
    "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": "11 PARKE PLACE BLVD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802664",
            "telephone_number": "856-553-6642",
            "fax_number": "856-553-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYDELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "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": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "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 24, 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.