HILLSIDE ESTATE INC
Custodial Care Facility
Williamsburg, Iowa
Provider NPI: 1215080635
Organization Information:Organization Name: HILLSIDE ESTATE INC
Practice Location:
2227 225TH ST WILLIAMSBURG, IA 52361 US
Tel: 319-668-1659 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2227 225TH ST WILLIAMSBURG, IA 52361 US
Tel: 319-668-1659 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | IA | R-653 |
X | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility | IA | R-653 |
X | 320600000X | Residential Treatment Facilities Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | IA | R-653 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0258624 | IA | 05 | |
0895219 | IA | 05 | |
0455170 | IA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin