Provider Demographics
NPI:1659811990
Name:HILLSIDE LIVING CENTER LLC
Entity Type:Organization
Organization Name:HILLSIDE LIVING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARPACI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-576-7328
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-0534
Mailing Address - Country:US
Mailing Address - Phone:573-562-0303
Mailing Address - Fax:573-562-7743
Practice Address - Street 1:10160 RESTORATION CIRCLE RD
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:MO
Practice Address - Zip Code:63660-8565
Practice Address - Country:US
Practice Address - Phone:573-562-0303
Practice Address - Fax:573-562-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044982310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility