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General NPI Number Information
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NPI Number | 1801882618
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Entity Type | Organization
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Legal Business Name | HILLSIDE NURSING AND REHABILITATION LP
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 101 S 34TH ST
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City | GATESVILLE
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State | TX
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Zip | 76528-2667
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Country | US
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Telephone | 254-865-8275
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Fax | 254-865-6344
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Provider Business Mailing Address
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Address Line | 401 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-4137
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Country | US
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Telephone | 940-387-4388
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Fax | 940-380-2410
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL A. RICH
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Credential |
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Telephone | 940-387-4388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 115886
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License Number State | TX
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