Provider Demographics
NPI:1083653463
Name:HILLTOP NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:HILLTOP NURSING & REHABILITATION CENTER LLC
Other - Org Name:HILLTOP NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TEDDY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-628-4116
Mailing Address - Street 1:336 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5445
Mailing Address - Country:US
Mailing Address - Phone:318-442-9552
Mailing Address - Fax:318-473-2640
Practice Address - Street 1:336 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5445
Practice Address - Country:US
Practice Address - Phone:318-442-9552
Practice Address - Fax:318-473-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA195390Medicare ID - Type UnspecifiedPROVIDER NUMBER