Collette Katrell Holmes

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

AL12677 Issued in FL

Practice address

2821 Hunt St
Jacksonville, FL 32254-4003

Phone

(904) 673-7212

NPI assigned

Sep 8, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• C and C Shelter Care LLC

  • In Home Supportive Care Agency
  • Jacksonville, FL
  • NPI 1629712013
  NPD Authorized official
• Grace Home Living Facility LLC

  • Assisted Living Facility
  • Jacksonville, FL
  • NPI 1467821512
  NPD Authorized official

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1932577970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 HUNT ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322544003",
            "telephone_number": "904-673-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 HUNT ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322544003",
            "telephone_number": "904-673-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "COLLETTE",
        "middle_name": "KATRELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "FL",
            "license": "AL12677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollywood Cuts
• Alexis Abigail Holmes
• Brittney Holmes, LM,CPM
• Carnell Holmes
• Chelsea Lauren Holmes, MSN, APRN
• Deanna Holmes, MSW
• Ebony N Holmes
• Elaine G Holmes, M.D.
• Kara Holmes
• Katherine Holmes, AU.D.

• Mental Illness Community Based Residential Treatment Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Illness Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.