Provider Demographics
NPI:1790423994
Name:JEFFERSON HILLS OPERATING LLC
Entity Type:Organization
Organization Name:JEFFERSON HILLS OPERATING LLC
Other - Org Name:JEFFERSON HILLS HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIDELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-385-5980
Mailing Address - Street 1:448 OLD CLAIRTON RD
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:448 OLD CLAIRTON RD
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3034
Practice Address - Country:US
Practice Address - Phone:412-653-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility