| NPI | 1043459852 |
|---|---|
| Other Name | HOLLY STREET HOME |
| Entity Type | Organization |
| Authorized Contact | TRACEY PRIDGEN CFO 919-734-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL-096-114) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2025-10-08 |