Organization
HOLIDAY AL NIC MANAGEMENT LLC
Active
Other names
HOLIDAY RETIREMENT
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE L THOMPSON (PARALEGAL FOR MANAGEMENT COMPANY)
(971) 245-8020
Entity
Organization
Contact information
Practice address
5885 MEADOWS RD, SUITE 500, LAKE OSWEGO, OR 97035-8639
(971) 245-8020
Mailing address
5885 MEADOWS RD, SUITE 500, LAKE OSWEGO, OR 97035-8639
(971) 245-8020
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009023200
—
FL
05
—
009091600
—
FL
05
—
009196100
—
FL
05
—
009421900
—
FL
05
—
009507900
—
FL
05
—
009678900
—
FL
05
—
009788900
—
FL
05
—
009789900
—
FL
05
—
009790400
—
FL
05
—
009792400
—
FL
05
—
009793200
—
FL
05
—
009793400
—
FL
05
—
009794200
—
FL
05
—
009794700
—
FL
05
—
7805631
—
NC
05
—
7805634
—
NC
Enumeration date
10/14/2016
Last updated
10/14/2016
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