Provider Demographics
NPI:1134662596
Name:HILLSDALE PARK REHAB CENTER LLC
Entity Type:Organization
Organization Name:HILLSDALE PARK REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-315-3400
Mailing Address - Street 1:245 BIRCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:383 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:PA
Practice Address - Zip Code:15746
Practice Address - Country:US
Practice Address - Phone:814-743-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility