Provider Demographics
NPI:1346247814
Name:HILLVIEW HEALTHCARE LLC
Entity Type:Organization
Organization Name:HILLVIEW HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:ROOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-324-4739
Mailing Address - Street 1:1615 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-2548
Mailing Address - Country:US
Mailing Address - Phone:414-671-6830
Mailing Address - Fax:414-671-6990
Practice Address - Street 1:1615 S 22ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-2548
Practice Address - Country:US
Practice Address - Phone:414-671-6830
Practice Address - Fax:414-671-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3230314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20180100Medicaid
5202210001OtherDME
WI525585Medicare ID - Type Unspecified