Provider Demographics
NPI:1063746329
Name:HOLLYWOOD SECRETS, LLC
Entity type:Organization
Organization Name:HOLLYWOOD SECRETS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SERDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TUYGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-636-1234
Mailing Address - Street 1:5116 BROWNSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-6029
Mailing Address - Country:US
Mailing Address - Phone:972-636-1234
Mailing Address - Fax:972-200-5587
Practice Address - Street 1:5116 BROWNSTONE DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-6029
Practice Address - Country:US
Practice Address - Phone:972-636-1234
Practice Address - Fax:972-200-5587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health