Organization
HILLSIDE MANOR REHABILITATION AND EXTENDED CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG WISSMANN (FINANCE DIRECTOR)
(718) 291-8200
Entity
Organization
Contact information
Practice address
18215 HILLSIDE AVE, JAMAICA, NY 11432-4853
(718) 291-8200
(718) 262-8651
Mailing address
18215 HILLSIDE AVE, JAMAICA, NY 11432-4853
(718) 291-8200
(718) 262-8651
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00318025
—
NY
Enumeration date
10/20/2006
Last updated
09/22/2008
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