HOLLYBROOK CARE FACILITY NPI 1508982695

NPI Information

  • NPI: 1508982695
  • Provider Name: HOLLYBROOK CARE FACILITY
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Address: 130 HARRIS STREET
    WENDELL, NC
    ZIP 27591
  • Phone: (919) 961-7515

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NPI Details

HOLLYBROOK CARE FACILITY is an adult care home custodial care facility in Wendell, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. HOLLYBROOK CARE FACILITY NPI is 1508982695. The provider is registered as an organization entity type.

The provider's business location address is:

130 HARRIS STREET
WENDELL, NC
ZIP 27591
Phone: (919) 961-7515

The provider's authorized official is Lucille Cooper .
The authorized official title is Owner and has the following contact phone number (919) 961-7515.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeMHL 092-561NORTH CAROLINAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17804889MEDICAIDNORTH CAROLINA

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: 11/21/2025

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