Basic Information
| Provider Information | |||||||||
| NPI: | 1861836306 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH HILL NURSING AND REHABILITATION CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3690 SOUTHWESTERN BLVD | ||||||||
| Address2: | P O BOX 0428 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166624955 | ||||||||
| FaxNumber: | 7166679230 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 N PINE HILL RD | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352171215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052388677 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2013 | ||||||||
| LastUpdateDate: | 08/21/2013 | ||||||||
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| AuthorizedOfficialLastName: | BENNETT | ||||||||
| AuthorizedOfficialFirstName: | NORBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7166624955 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 150890 | 05 | AL | MEDICAID |