Provider Demographics
NPI:1437127024
Name:HILLCREST HOUSE
Entity Type:Organization
Organization Name:HILLCREST HOUSE
Other - Org Name:LMC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-241-6693
Mailing Address - Street 1:2107 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-8128
Mailing Address - Country:US
Mailing Address - Phone:620-241-6693
Mailing Address - Fax:620-241-6699
Practice Address - Street 1:2322 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6093
Practice Address - Country:US
Practice Address - Phone:620-342-8601
Practice Address - Fax:620-342-8629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTI COMMUNITY DIVERSIFIED SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-09
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN-056-008315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100108380DMedicaid
KS100108380IMedicaid