Hollyhock Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HOLLYHOCK ASSISTED LIVING LLC

Practice address

16552 N Hollyhock St
Surprise, AZ 85378-3667

Phone

(160) 233-2078

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Rebecca Siddiqui

Title

Administrator

Phone

(602) 332-0780

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hollyhock Assisted Living LLC Doing business as

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1801548474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16552 N HOLLYHOCK ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783667",
            "telephone_number": "160-233-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16552 N HOLLYHOCK ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783667",
            "telephone_number": "160-233-2078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16552 N Hollyhock St",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783667",
            "country_code": "US",
            "telephone_number": "602-332-0780",
            "fax_number": "877-517-2224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16552 N Hollyhock St",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783667",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16552 N Hollyhock St",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783667",
            "country_code": "US",
            "telephone_number": "602-332-0780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16552 N Hollyhock St",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783667",
            "country_code": "US",
            "telephone_number": "602-332-0780",
            "fax_number": "877-517-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLLYHOCK ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-332-0780"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollyhock Assisted Living LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delia Hoke-McCarthy, MS., ED., NCSP
• Maressa Holland
• Daniel Holloway, OD
• George Allen Holloway Jr., MD
• Jennifer Nowell Holloway, LMFT
• Kailey Victoria Holm
• Jessica L Holmquist, PA-C
• Paige Alexandra Holt, RN
• Steven R Holt, OD
• Honorhealth

• All providers in Surprise, AZ
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.