Holland Lake SCC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HOLLAND LAKE SCC LLC

Doing business as

Holland Lake Nursing & Rehab

Practice address

1201 Holland Lake Dr
Weatherford, TX 76086-5851

Phone

(817) 598-0160

NPI assigned

Oct 21, 2015

Organization subpart

No

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

Authorized official

Name

Michael Templeton

Title

Chief Operations Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Holland Lake Nursing & Rehab Doing business as

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1790157519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547685",
            "telephone_number": "214-252-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HOLLAND LAKE DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865851",
            "telephone_number": "817-598-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLAND LAKE SCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "TEMPLETON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027377",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holland Lake Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Christine Hobbs, LVN
• Hode Internal Medicine, PLLC
• Renee Hoffman, LPC,BCBA
• Brandi Hohm
• Holland Lake Nursing Center LTD
• David Zane Holley, DPT
• Marcia Holweger
• Brent Edgar Hood, D.C.
• Devin Hooks
• Jorden Lynn Hooper, RBT

• Skilled Nursing Facility in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.