Provider Demographics
NPI:1699852798
Name:UHHS - HEATHER HILL REHABILITATION HOSPITAL INC
Entity Type:Organization
Organization Name:UHHS - HEATHER HILL REHABILITATION HOSPITAL INC
Other - Org Name:UNIVERSITY HOSPITALS EXTENDED CARE CAMPUS - HH SNF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UHHS DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-605-1258
Mailing Address - Street 1:12340 BASS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8327
Mailing Address - Country:US
Mailing Address - Phone:440-605-1258
Mailing Address - Fax:440-605-1260
Practice Address - Street 1:12340 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8327
Practice Address - Country:US
Practice Address - Phone:440-605-1258
Practice Address - Fax:440-605-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0025743Medicaid
OH36-5053Medicare Oscar/Certification