Doctor Name: | MRS. LANISHA J HOLLOWAY |
NPI Number: | 1497039143 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 12059 |
Business Practice Address: | 5022 Perrine Dr Jacksonville, FL - 322107859 |
Business Phone Number: | 9047720651 |
Business Fax Number: | 9044385726 |
Mailing Address: | 8225 Leafcrest Dr, JACKSONVILLE |
State: | FL |
Postal Code: | 322447493 |
Phone Number: | 9042102685 |
Fax Number: | 9044385726 |
NPI Enumeration Date: | 09/29/2011 |
NPI Last Update Date: | 10/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 12059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |