Provider Demographics
NPI:1316919970
Name:HILLSIDE TERRACE OF HALLOWELL, LLC
Entity type:Organization
Organization Name:HILLSIDE TERRACE OF HALLOWELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL SERVICES CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIROIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-872-8992
Mailing Address - Street 1:21 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347-1230
Mailing Address - Country:US
Mailing Address - Phone:207-622-5644
Mailing Address - Fax:207-621-8175
Practice Address - Street 1:21 WARREN ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1230
Practice Address - Country:US
Practice Address - Phone:207-622-5644
Practice Address - Fax:207-621-8175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS1549310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility