National Provider Identifier Database

CREATIVE HOUSING III MT HOLLY
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

CREATIVE HOUSING III-MT HOLLY
1215 MOUNT HOLLY RD
EL DORADO, AR71730-4236
Phone: 870-863-8194
Fax: 870-881-4600
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for CREATIVE HOUSING III-MT HOLLY

NPI Number 1952427569
Legal business name
LBN
CREATIVE HOUSING III-MT HOLLY
Authorized official BARBARA STAGGS - (BUSINESS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 03/22/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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