National Provider Identifier Database

HOLLYBROOK CARE FACILITY
Adult Care Home

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.


Contact Information

HOLLYBROOK CARE FACILITY
130 HARRIS STREET
WENDELL, NC27591
Phone: 919-961-7515
Fax:
Website:
Specialty Taxonomy Code
* Adult Care Home 311ZA0620X

* Indicates primary specialty

NPI Profile & details for HOLLYBROOK CARE FACILITY

NPI Number 1508982695
Legal business name
LBN
HOLLYBROOK CARE FACILITY
Authorized official LUCILLE COOPER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/21/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • NC License #: MHL 092-561
  • NC Medicaid: 7804889

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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