Provider Demographics
NPI:1235908724
Name:HOLIDAY'S ADULT CARE AT HOME
Entity Type:Organization
Organization Name:HOLIDAY'S ADULT CARE AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PALENA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:HOLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:517-240-8275
Mailing Address - Street 1:553 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1019
Mailing Address - Country:US
Mailing Address - Phone:517-240-8275
Mailing Address - Fax:517-962-5002
Practice Address - Street 1:553 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1019
Practice Address - Country:US
Practice Address - Phone:517-240-8275
Practice Address - Fax:517-962-5002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLIDAY'S ADULT CARE AT HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health