Provider Demographics
NPI:1588433072
Name:ROCKY HOLLOW CABINS, LLC
Entity type:Organization
Organization Name:ROCKY HOLLOW CABINS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAZARALI
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-793-2311
Mailing Address - Street 1:1650 COUNTY ROAD 245
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4476
Mailing Address - Country:US
Mailing Address - Phone:254-793-2311
Mailing Address - Fax:254-793-2554
Practice Address - Street 1:1650 COUNTY ROAD 245
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-4476
Practice Address - Country:US
Practice Address - Phone:254-793-2311
Practice Address - Fax:254-793-2554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility