Provider Demographics
NPI:1801054309
Name:HILLSDALE NURSING AND REHABILITATION CENTER LP
Entity type:Organization
Organization Name:HILLSDALE NURSING AND REHABILITATION CENTER LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DOMINIC
Authorized Official - Last Name:D'ACCANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-441-7700
Mailing Address - Street 1:200 DRYDEN ROAD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1048
Mailing Address - Country:US
Mailing Address - Phone:215-441-7700
Mailing Address - Fax:215-441-4255
Practice Address - Street 1:383 MOUNTAIN VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:PA
Practice Address - Zip Code:15746
Practice Address - Country:US
Practice Address - Phone:215-441-7700
Practice Address - Fax:215-441-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA134402314000000X
313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102156498000IMedicaid
PA395569Medicare Oscar/Certification