Healthcare Provider Details

I. General information

NPI: 1447219019
Provider Name (Legal Business Name): HOLLYWOOD HILLS REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N 35TH AVE
HOLLYWOOD FL
33021-5413
US

IV. Provider business mailing address

1200 N 35TH AVE
HOLLYWOOD FL
33021-5413
US

V. Phone/Fax

Practice location:
  • Phone: 954-981-5511
  • Fax: 954-981-7229
Mailing address:
  • Phone: 954-981-5511
  • Fax: 954-981-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1238096
License Number StateFL

VIII. Authorized Official

Name: JON STEINMEYER
Title or Position: RECEIVER
Credential: NHA
Phone: 305-851-1788