HOLIDAY AL NIC MANAGEMENT LLC NPI 1972054989

NPI Information

NPI: 1972054989
Provider Name: HOLIDAY AL NIC MANAGEMENT LLC

Doing Business As: HOLIDAY RETIREMENT

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
5885 MEADOWS RD
SUITE 500
LAKE OSWEGO, OR
ZIP 97035
Phone: (971) 245-8020
Get Directions

HOLIDAY AL NIC MANAGEMENT LLC is an assisted living facility in Lake Oswego, OR. 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 AL NIC MANAGEMENT LLC NPI is 1972054989. The provider is registered as an organization entity type.
The provider Is Doing Business As Holiday Retirement.

The provider's business location address is:

5885 MEADOWS RD
SUITE 500
LAKE OSWEGO, OR
ZIP 97035-639
Phone: (971) 245-8020

The provider's authorized official is Diane L Thompson .
The authorized official title is Paralegal For Management Company and has the following contact phone number (971) 245-8020.

The enumeration date for this NPI number is 10/14/2016 and was last updated on 10/14/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	009678900	MEDICAID	FLORIDA
2	009788900	MEDICAID	FLORIDA
3	7805634	MEDICAID	NORTH CAROLINA
4	009792400	MEDICAID	FLORIDA
5	009793200	MEDICAID	FLORIDA
6	009196100	MEDICAID	FLORIDA
7	009794700	MEDICAID	FLORIDA
8	009091600	MEDICAID	FLORIDA
9	009421900	MEDICAID	FLORIDA
10	009507900	MEDICAID	FLORIDA
11	009789900	MEDICAID	FLORIDA
12	7805631	MEDICAID	NORTH CAROLINA
13	009023200	MEDICAID	FLORIDA
14	009790400	MEDICAID	FLORIDA
15	009793400	MEDICAID	FLORIDA
16	009794200	MEDICAID	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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