Provider Demographics
NPI:1528414414
Name:HILLSIDE HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:HILLSIDE HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COFOUNDER CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:202-813-5993
Mailing Address - Street 1:3522 TERRACE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2837
Mailing Address - Country:US
Mailing Address - Phone:202-813-5993
Mailing Address - Fax:
Practice Address - Street 1:3522 TERRACE DR
Practice Address - Street 2:SUITE C
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2837
Practice Address - Country:US
Practice Address - Phone:202-813-5993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care