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NPI Code Detail

MEDICARE: HILLHAVEN SNF OPERATOR LLC

MEDICARE: HILLHAVEN SNF OPERATOR LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1184312100
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILLHAVEN SNF OPERATOR LLC
Provider Business Mailing Address
First Line : 3210 POWDER MILL RD
Second Line :
City : ADELPHI
State : MD
Zip : 20783-1029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3210 POWDER MILL RD
Second Line :
City : ADELPHI
State : MD
Zip : 20783-1029
Country : US
Telephone Number : 240-542-6361
Fax Number :
Authorized Official
Title or Position : AUTHORIZED SIGNER
Name : JEFFREY KAGAN
Credential :
Telephone Number : 732-961-8432
Provider Enumeration Date : 04/27/2023
Last Update Date : 04/27/2023

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Directions to “HILLHAVEN SNF OPERATOR LLC ” Practice Location

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