Provider Demographics
NPI:1346821220
Name:HILLCREST CENTER
Entity Type:Organization
Organization Name:HILLCREST CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-824-2091
Mailing Address - Street 1:400 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:WANAMINGO
Mailing Address - State:MN
Mailing Address - Zip Code:55983-1464
Mailing Address - Country:US
Mailing Address - Phone:507-824-2091
Mailing Address - Fax:507-824-2249
Practice Address - Street 1:400 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:WANAMINGO
Practice Address - State:MN
Practice Address - Zip Code:55983-1464
Practice Address - Country:US
Practice Address - Phone:507-824-2091
Practice Address - Fax:507-824-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care