Healthcare Provider Details

I. General information

NPI: 1114753787
Provider Name (Legal Business Name): INSIGHT FOUNDATION OF HILLSIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 12/28/2024
Certification Date: 12/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8747 SQUIRES LN NE
WARREN OH
44484-1649
US

IV. Provider business mailing address

4800 S SAGINAW ST
FLINT MI
48507-2677
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-9011
  • Fax:
Mailing address:
  • Phone: 810-275-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: ROBIN COLE
Title or Position: DIRECTOR
Credential:
Phone: 810-275-9333