# HILLSIDE VILLAGE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801997101
- **Authorized official:** MR. MICHAEL FRANK EGAN (CEO)
- **Authorized official phone:** (913) 583-1260

## Contact information

- **Practice address:** 33600 W 85TH, DESOTO, KS 66018
- **Practice address phone:** (913) 558-3126
- **Practice address fax:** (913) 585-1225
- **Mailing address:** 33600 W 85TH, DESOTO, KS 66018
- **Mailing address phone:** (913) 558-3126
- **Mailing address fax:** (913) 585-1225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | N046064 | KS | — |
| 314000000X | Skilled Nursing Facility | N046064 | KS | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 02/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100644420A | — | KS |
| 05 | — | 100644420B | — | KS |
| 05 | — | 1042049201 | — | KS |