Provider Demographics
NPI:1447247366
Name:HILLSIDE RESIDENTIAL CARE FACILITY
Entity type:Organization
Organization Name:HILLSIDE RESIDENTIAL CARE FACILITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:RING
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:978-388-1010
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:HILLSIDE REST HOME INC
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-0002
Mailing Address - Country:US
Mailing Address - Phone:978-388-1010
Mailing Address - Fax:978-388-6817
Practice Address - Street 1:29 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2228
Practice Address - Country:US
Practice Address - Phone:978-388-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5508894Medicaid