Hillside Manor Rehabilitation and Extended Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HILLSIDE MANOR REHABILITATION AND EXTENDED CARE CENTER, LLC

Doing business as

Hillside Manor Adult Day Health Care Program

Practice address

18811 Hillside Ave
Hollis, NY 11423-1935

Phone

(718) 264-6700

Fax

(718) 264-6777

NPI assigned

Oct 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Doug Wissmann

Title

Finance Director

Phone

(718) 291-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hillside Manor Adult Day Health Care Program Doing business as

Tax ID family

Hillside Manor Adult Day Health Care Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hillside Manor Rehabilitation and Extended Care Center, LLC

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1043392657
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902988462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18811 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231935",
            "telephone_number": "718-264-6700",
            "fax_number": "718-264-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18811 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231935",
            "telephone_number": "718-264-6700",
            "fax_number": "718-264-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE MANOR REHABILITATION AND EXTENDED CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WISSMANN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "718-291-8200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02065901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Manor Adult Day Health Care Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Israel Yao Hiamaley, LPN
• Hillside Anesthesiology PC
• Hillside Family Dental PC
• Hillside Manor Rehabilitation and Extended Care Center, LLC (Hillside Manor Long Term Home Health Care Program)
• Hillside Manor Rehabilitation and Extended Care Center, LLC (Hillside Manor Certified Home Health Agency)
• Hillside Neurology Care,P.C.
• Hillside Open MRI PC
• Hillside Optimal Medical Care
• Hillside PC
• Fred Hoffman, RPH

• Skilled Nursing Facility in Hollis, NY
• Providers in Hollis, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.