Provider Type Icon

HOLLY LANE REHABILITATION AND HEALTHCARE CENTER LLC NPI 1053553461


NPI Information

NPI: 1053553461
Provider Name: HOLLY LANE REHABILITATION AND HEALTHCARE CENTER, LLC
Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization
Address:
2105 12TH AVE RD
NAMPA, ID
ZIP 83686
Phone: (208) 467-5721
Get Directions

HOLLY LANE REHABILITATION AND HEALTHCARE CENTER, LLC is a skilled nursing facility in Nampa, ID. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. HOLLY LANE REHABILITATION AND HEALTHCARE CENTER, LLC NPI is 1053553461. The provider is registered as an organization entity type.

The provider's business location address is:

2105 12TH AVE RD
NAMPA, ID
ZIP 83686-312
Phone: (208) 467-5721
Fax: (208) 467-2748

The provider's authorized official is Craig E Robinson .
The authorized official title is President and has the following contact phone number (901) 937-7994.

The enumeration date for this NPI number is 3/31/2009 and was last updated on 7/11/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing FacilityAPPLIED FORIDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1135094MEDICARE OSCAR/CERTIFICATION
2APPLIED FORMEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.