Provider Demographics
NPI:1386360220
Name:HOLLAND THERAPY GROUP
Entity type:Organization
Organization Name:HOLLAND THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:810-877-5532
Mailing Address - Street 1:20347 N MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3617
Mailing Address - Country:US
Mailing Address - Phone:810-877-5532
Mailing Address - Fax:
Practice Address - Street 1:20347 N MEADOW LN
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:IL
Practice Address - Zip Code:60010-3617
Practice Address - Country:US
Practice Address - Phone:864-688-9097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty