NPIMap

Organization Active NPI

Holly Hill Hospital LLC

  • Psychiatric Hospital
  • Louisburg, NC
National Provider Identifier
1750508248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
4724 Issued in NC
Legal business name
HOLLY HILL HOSPITAL LLC
Practice address
107 Industrial Dr
Louisburg, NC 27549-2371
Phone
(919) 496-3444
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tom Ryba
Title
Chief Executive Officer
Phone
(919) 250-7186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 4724 NC Primary

Addresses

Primary practice location

107 Industrial Dr
Louisburg, NC 27549-2371

Mailing address

3019 Falstaff Rd
Raleigh, NC 27610-1812
Phone (919) 250-7000

Other identifiers 1

IdentifierTypeStateIssuer
6102735MedicaidNC

Other names 1

  • PSI INC OF NC DBA HOLLY HILL Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Holly Hill Hospital LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750508248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 FALSTAFF RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101812",
            "telephone_number": "919-250-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INDUSTRIAL DR",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492371",
            "telephone_number": "919-496-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY HILL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYBA",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-250-7186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NC",
            "license": "4724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102735",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSI INC OF NC DBA HOLLY HILL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Louisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.