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HOLIDAY ISLAND OPERATIONS LLC NPI 1427444124


NPI Information

NPI: 1427444124
Provider Name: HOLIDAY ISLAND OPERATIONS, LLC

Doing Business As: GREEN ACRE LODGE OF HOLIDAY ISLAND

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
89 HILLSIDE DRIVE
HOLIDAY ISLAND, AR
ZIP 72631
Phone: (479) 253-6553
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HOLIDAY ISLAND OPERATIONS, LLC is an assisted living facility in Holiday Island, AR. The provider is 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. HOLIDAY ISLAND OPERATIONS, LLC NPI is 1427444124. The provider is registered as an organization entity type.
The provider Is Doing Business As Green Acre Lodge Of Holiday Island.

The provider's business location address is:

89 HILLSIDE DRIVE
HOLIDAY ISLAND, AR
ZIP 72631
Phone: (479) 253-6553
Fax: (479) 253-5043

The provider's authorized official is Raymond Dennington Moss .
The authorized official title is Manager and has the following contact phone number (479) 530-3779.

The enumeration date for this NPI number is 4/9/2015 and was last updated on 4/9/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility105ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1206460794MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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