Basic Information
| Provider Information | |||||||||
| NPI: | 1134721434 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HILLTOP LODGE HEALTH AND REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 N INDEPENDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | BELOIT | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674201639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7857383515 | ||||||||
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| Practice Location | |||||||||
| Address1: | 815 N INDEPENDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | BELOIT | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674201639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7857383515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2020 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | FREUND | ||||||||
| AuthorizedOfficialFirstName: | NOCHUM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 1879423483 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.