HOLLY HILLS RETIREMENT HOME (NPI# 1275910341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275910341 |
| Entity Type | Organization |
| Organization Name | HOLLY HILLS RETIREMENT HOME |
| Practice Address |
6421 Minnesota Ave Saint Louis MO 63111-2808 |
| Practice Telephone | 3146303543 |
| Mailing Telephone | 3146303543 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |
| Authorized Official Name | CHRISTOPHER MICHAEL VANCIL (OWNER) |
| Authorized Official Telephone | 3146303543 |
| Is Organization Subpart | Y |
| Parent Organization Name | MISSOURI RESIDENTIAL CARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 043055 | MO | Nursing & Custodial Care Facilities |
| Street Address |
6421 MINNESOTA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63111-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992291660 | Ebony Cannon | Behavior Technician | 7700 Minosotta Ave, St.louis, MO 63111 | 2018-07-06 |
| 1811310212 | Danny Brown | Home Health | 5328 Virginia, Saint Louis, MO 63111 | 2014-01-22 |
| 1548387681 | Raymond Joseph Skosky | Dentist | 5530 Virginia Avenue, Saint Louis, MO 63111 | 2007-03-23 |
| 1972666782 | Diane P Hamill | Optometrist | 1012 Loughborough Commons, St. Louis, MO 63111 | 2006-12-19 |
| 1073673828 | Bethesda Long Term Care, Inc. | Custodial Care Facility | 4431 South Broadway, St. Louis, MO 63111 | 2006-12-11 |
| 1669542668 | Anna D Naumovich | Internal Medicine | 5205 South Grand Ave, St Louis, MO 63111 | 2006-11-08 |
| 1417040114 | Tony Thien Tang | Internal Medicine | 4675 South Grand Blvd., St. Louis, MO 63111 | 2006-10-02 |
| 1790736171 | Robert Clarence Egan | Surgery | 3535 South Jefferson Ste 101, Ste 101, St Louis, MO 63111 | 2006-05-12 |
| 1790340438 | Marco Samuel Garcia | Student in an Organized Health Care Education/Training Program | 401 Holly Hills Ave, Saint Louis, MO 63111 | 2019-05-08 |
| 1154717593 | Nucrown, LLC | Optometrist | 1012 Loughborough Commons, Saint Louis, MO 63111 | 2015-04-13 |
| Find all providers in zip 63111 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912462037 | Dunn-dunn House LLC | Assisted Living Facility | 2133 Jannette Dr, Saint Louis, MO 63136-4020 | 2019-02-02 |
| 1932608932 | Sw Living LLC | Assisted Living Facility | 1501 Clinton St, Saint Louis, MO 63106-4100 | 2018-02-05 |
| 1790295558 | Avalon Memory Care, LLC | Assisted Living Facility | 5342 Butler Hill Rd, Saint Louis, MO 63128-4152 | 2017-10-06 |
| 1275074957 | Americare At South St. Louis, LLC | Assisted Living Facility | 4962 Mattis Rd, Saint Louis, MO 63128-2795 | 2017-03-15 |
| 1326400888 | Shonta Clark | Assisted Living Facility | 325 Rose Ln, Saint Louis, MO 63122-5911 | 2016-03-24 |
| 1184001836 | Carondelet Retirement Manor | Assisted Living Facility | 6811 Michigan Ave, Saint Louis, MO 63111-2834 | 2015-05-01 |
| 1487044293 | Neelum LLC | Assisted Living Facility | 3610 Palm St, Saint Louis, MO 63107-2206 | 2015-02-01 |
| 1104235548 | Garden Villas of South County, Inc. | Assisted Living Facility | 13457 Tesson Ferry Rd, Saint Louis, MO 63128-4010 | 2014-08-11 |
| 1124439708 | St. Anthony's Physician Organization | Assisted Living Facility | 9735 Landmark Parkway Dr Ste 200, Saint Louis, MO 63127-1666 | 2014-05-16 |
| 1245670512 | Mcknight Place Assisted Living, L.L.C. | Assisted Living Facility | 3 Mcknight Pl, Saint Louis, MO 63124-1900 | 2013-07-01 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63111 |
Please comment or provide details below to improve the information on HOLLY HILLS RETIREMENT HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.