Provider Demographics
NPI:1295159903
Name:HILLSIDE GARDENS INC
Entity type:Organization
Organization Name:HILLSIDE GARDENS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-455-6566
Mailing Address - Street 1:1749 MAPLELEAF BLVD
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2729
Mailing Address - Country:US
Mailing Address - Phone:727-455-6566
Mailing Address - Fax:
Practice Address - Street 1:3434 ZARA WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1225
Practice Address - Country:US
Practice Address - Phone:727-789-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8007310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility