NPIMap

Organization Active NPI

A Hollyhome Alf, Inc

  • Assisted Living Facility
  • Port Saint Lucie, FL
National Provider Identifier
1649437229
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
10818 Issued in FL
Legal business name
A HOLLYHOME ALF, INC
Practice address
5288 NW North Macedo Blvd
Port Saint Lucie, FL 34983-1464
Phone
(772) 807-9438
NPI assigned
May 21, 2008
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Mrs. Holly Lynne Dickson, RN
Title
Owner
Phone
(772) 807-9438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 10818 FL Primary

Addresses

Primary practice location

5288 NW North Macedo Blvd
Port Saint Lucie, FL 34983-1464

Mailing address

5288 NW North Macedo Blvd
Port Saint Lucie, FL 34983-1464
Phone (772) 807-9438

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1649437229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5288 NW NORTH MACEDO BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831464",
            "telephone_number": "772-807-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5288 NW NORTH MACEDO BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831464",
            "telephone_number": "772-807-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A HOLLYHOME ALF, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-807-9438",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.