Healthcare Provider Details

I. General information

NPI: 1790058071
Provider Name (Legal Business Name): HILLTOP HEALTH CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 LUELLA ST
WATKINS MN
55389-1012
US

IV. Provider business mailing address

6069 HIDDEN LN
SOUTH HAVEN MN
55382-4505
US

V. Phone/Fax

Practice location:
  • Phone: 320-764-2300
  • Fax:
Mailing address:
  • Phone: 320-255-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FRED STRUZYK
Title or Position: PRINCIPAL
Credential:
Phone: 320-255-9188