1285695270 NPI number — HILLCREST HEALTHCARE COMMUNITIES INC

Table of content: (NPI 1285695270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285695270 NPI number — HILLCREST HEALTHCARE COMMUNITIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILLCREST HEALTHCARE COMMUNITIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST HILLS HEALTH AND REHAB
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285695270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6801 MIDDLEBROOK PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-588-7661
Provider Business Mailing Address Fax Number:
865-246-4054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 MIDDLEBROOK PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-588-7661
Provider Business Practice Location Address Fax Number:
865-246-4054
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FUGATE-DAY
Authorized Official First Name:
LESA
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL COUNSEL
Authorized Official Telephone Number:
865-414-3695

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , with the licence number:  145 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 313M00000X , with the licence number: 0000000145 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 0000000145 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 314000000X , with the licence number: 145 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000000145 . This is a "NH LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7440603 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0445466 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7440207 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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