Organization
HOLIDAY ISLAND OPERATIONS, LLC
Active
Other names
Green Acre Lodge of Holiday Island
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DENNINGTON MOSS (MANAGER)
(479) 530-3779
Entity
Organization
Contact information
Practice address
89 HILLSIDE DRIVE, HOLIDAY ISLAND, AR 72631
(479) 253-6553
(479) 253-5043
Mailing address
89 HILLSIDE DRIVE, HOLIDAY ISLAND, AR 72631
(479) 253-6553
(479) 253-5043
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
105
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206460794
—
AR
Enumeration date
04/09/2015
Last updated
04/09/2015
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