Peachtree Village at Holiday Island

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

002 Issued in AR

Legal business name

PEACHTREE VILLAGE AT HOLIDAY ISLAND

Practice address

5 Park Dr
Holiday Island, AR 72631-9388

Phone

(479) 253-9933

NPI assigned

Apr 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Janet L. Nordlie

Title

Operating Manager

Phone

(719) 200-3049

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1043743768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PARK DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319388",
            "telephone_number": "479-253-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PARK DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319388",
            "telephone_number": "479-253-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE VILLAGE AT HOLIDAY ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "NORDLIE",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OPERATING MANAGER",
        "authorized_official_telephone_number": "719-200-3049"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Jones, COTA
• Andy Langston, OD, PA
• Danyal Loftin, PTA
• Mercy Clinic Springfield Communities
• Reilly Nichols
• Jeffery L. Price, PHARM.D.
• Ptworks,P.a.
• Ana Rebeca Rodriguez, LPC
• Carlie Rose
• Steve Rose, MD

• All providers in Holiday Island, AR
• Assisted Living Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.