Healthcare Provider Details

I. General information

NPI: 1720979875
Provider Name (Legal Business Name): HOLIDAY OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SAYLES HILL RD
MANVILLE RI
02838-1227
US

IV. Provider business mailing address

30 SAYLES HILL RD
MANVILLE RI
02838-1227
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-1440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MINDEE POSEN
Title or Position: MEDICARE ADMINISTRATION OFFICER
Credential:
Phone: 845-825-2217