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General NPI Number Information
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NPI Number | 1295159903
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Entity Type | Organization
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Legal Business Name | HILLSIDE GARDENS INC
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Dates
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Enumeration Date | 02/17/2014
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 3434 ZARA WAY
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City | CLEARWATER
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State | FL
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Zip | 33761-1225
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Country | US
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Telephone | 727-789-0291
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Fax |
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Provider Business Mailing Address
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Address Line | 1749 MAPLELEAF BLVD
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City | OLDSMAR
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State | FL
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Zip | 34677-2729
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Country | US
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Telephone | 727-455-6566
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DORIS SALVAS
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Credential |
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Telephone | 727-455-6566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL8007
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License Number State | FL
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