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Organization

HILLSIDE VILLAGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL FRANK EGAN (CEO)
(913) 583-1260
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
N046064
KS
314000000X
Skilled Nursing Facility
Primary
N046064
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100644420A
KS
05
100644420B
KS
05
1042049201
KS
Enumeration date
09/26/2006
Last updated
02/09/2012
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