Hollis Haven LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HOLLIS HAVEN LLC

Practice address

8046 County Road 3010
West Plains, MO 65775-4949

Phone

(417) 274-3730

Fax

(417) 255-0574

NPI assigned

Jan 1, 2011

Organization subpart

No

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

Authorized official

Name

Mendy Hufstedler, RN

Title

Owner/Administrator

Phone

(417) 274-3730

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1293840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293840000000",
    "number": "1669776852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 COUNTY ROAD 3010",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754949",
            "telephone_number": "417-274-3730",
            "fax_number": "417-255-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 COUNTY ROAD 3010",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754949",
            "telephone_number": "417-274-3730",
            "fax_number": "417-255-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLIS HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-01",
        "last_updated": "2011-01-01",
        "status": "A",
        "authorized_official_last_name": "HUFSTEDLER",
        "authorized_official_first_name": "MENDY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "417-274-3730",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Hogan
• Travis Hohenbery, DO
• Stacey Holland
• Crystal Holley
• Rhonda Hollingshad
• Shelley Dawn Hollis, PT
• Sydney Hollis
• Cheryl Holloway
• Rachel Holloway
• Walter R Holloway, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in West Plains, MO
• Providers in West Plains, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2011; 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.