Provider Demographics
NPI:1346302452
Name:HILLSIDE NURSING AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:HILLSIDE NURSING AND REHABILITATION, LLC
Other - Org Name:HILLSIDE NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-772-1105
Mailing Address - Street 1:7261 ENGLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8467
Mailing Address - Country:US
Mailing Address - Phone:216-772-1105
Mailing Address - Fax:
Practice Address - Street 1:299 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SEAMAN
Practice Address - State:OH
Practice Address - Zip Code:45679-7516
Practice Address - Country:US
Practice Address - Phone:937-386-6375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH365906Medicare ID - Type Unspecified