- Enrollment id
- O20191023003195
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1982601670
- Multiple npi flag
- N
- Ccn
- 105343
- Associate id
- 4183706427
- Organization name
- HEATHER HILL NURSING CENTER LLC
- Doing business as name
- HEATHER HILL HEALTHCARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Nursing home provider name
- HEATHER HILL HEALTHCARE CENTER
- Affiliation entity name
- HEALTH SERVICES MANAGEMENT
- Affiliation entity id
- 257
- Address line 1
- 6630 KENTUCKY AVE
- City
- NEW PORT RICHEY
- State
- FL
- Zip code
- 346532712