SOUTH HOLLAND HOME LLC NPI 1053768150

NPI Information

SOUTH HOLLAND HOME, LLC is an assisted living facility in South Holland, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SOUTH HOLLAND HOME, LLC NPI is 1053768150. The provider is registered as an organization entity type.
The provider Is Doing Business As Holland Home.

The provider's business location address is:

16300 LOUIS AVE
SOUTH HOLLAND, IL
ZIP 60473-281
Phone: (708) 596-3050

The provider's authorized official is Benjamin Israel .
The authorized official title is Manager and has the following contact phone number (847) 440-2660.

The CLIA number assigned to this NPI record is 14D0714335 - other - shelter care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2016 and was last updated on 5/18/2016.

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:

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