Provider Demographics
NPI:1447219019
Name:HOLLYWOOD HILLS REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:HOLLYWOOD HILLS REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEIVER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:305-851-1788
Mailing Address - Street 1:1200 N 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5413
Mailing Address - Country:US
Mailing Address - Phone:954-981-5511
Mailing Address - Fax:954-981-7229
Practice Address - Street 1:1200 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5413
Practice Address - Country:US
Practice Address - Phone:954-981-5511
Practice Address - Fax:954-981-7229
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH RIDGE MANAGEMENT CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-21
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1238096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031342400Medicaid
FLN70OtherBLUE CROSS
FL031342400Medicaid