Provider Demographics
NPI:1427800382
Name:HOLLOWAY HOME CARE INC.
Entity type:Organization
Organization Name:HOLLOWAY HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERIC
Authorized Official - Middle Name:LECHARLES
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:914-325-7197
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-0512
Mailing Address - Country:US
Mailing Address - Phone:914-325-7197
Mailing Address - Fax:
Practice Address - Street 1:36 MILL PLAIN RD STE 310
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5114
Practice Address - Country:US
Practice Address - Phone:914-325-7197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care