MEDICARE: HOLIDAY CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	061526	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063409589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLIDAY CARE CENTER INC

Provider Business Mailing Address
First Line	:	1730 RTE 37 W
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-2345
Country	:	US
Telephone Number	:	732-244-1400
Fax Number	:	732-244-1404

Provider Business Practice Location Address
First Line	:	4 PLAZA DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-3756
Country	:	US
Telephone Number	:	732-240-0900
Fax Number	:

Authorized Official
Title or Position	:	AR SUPERVISOR
Name	:	MS. LILLI A GEARY
Credential	:
Telephone Number	:	732-244-1400

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	08/22/2020

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