Holiday Island Operations, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HOLIDAY ISLAND OPERATIONS, LLC

Doing business as

Prestige Assisted Living

Practice address

89 Hillside Dr
Holiday Island, AR 72631-4658

Phone

(479) 530-3779

NPI assigned

Jul 27, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond Dennington Moss

Title

Owner

Phone

(479) 530-3779

Specialties & licenses 1

Addresses

Other names 1

• Prestige Assisted Living Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Green Acre Lodge of Holiday Island2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Holiday Island Operations, LLC

  dba Green Acre Lodge of Holiday Island

  • Assisted Living Facility
  • Holiday Island, AR
  • NPI 1427444124
  NPD tax ID

Locations

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1497481832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 HILLSIDE DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726314658",
            "telephone_number": "479-530-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 HILLSIDE DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726314658",
            "telephone_number": "479-530-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY ISLAND OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "DENNINGTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-530-3779"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evecutivedirector@prestigeassistedliving.com",
            "affiliation": "N",
            "endpointDescription": "director email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "89 Hillside Dr",
            "city": "Holiday Island",
            "state": "AR",
            "country_code": "US",
            "postal_code": "726314658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prestige Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Green Acre Lodge Inc.
• Jharry Ann Santos Gumabon, COTA/L
• Daxton Harris
• Jamie Holden, PTA
• Holiday Island Operations, LLC (Green Acre Lodge of Holiday Island)
• Holiday Island Pharmacy, LLC (Holiday Island Pharmacy)
• Amy Johnson, RPH
• Kristin Jones, COTA
• Lindsey Jones, COTA
• Andy Langston, OD, PA

• Community/Behavioral Health Agency in Holiday Island, AR
• Providers in Holiday Island, AR by specialty
• Community/Behavioral Health Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.