Provider Demographics
NPI:1619124849
Name:HILLCREST DEVELOPMENT COMPANY LLC
Entity Type:Organization
Organization Name:HILLCREST DEVELOPMENT COMPANY LLC
Other - Org Name:HILLCREST COUNTRY ESTATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHISON ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-682-4800
Mailing Address - Street 1:6082 GRAND LODGE AVE
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-3200
Mailing Address - Country:US
Mailing Address - Phone:402-885-7000
Mailing Address - Fax:402-885-7001
Practice Address - Street 1:6082 GRAND LODGE AVE
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-3200
Practice Address - Country:US
Practice Address - Phone:402-885-7000
Practice Address - Fax:402-885-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENH0007314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENH0007OtherSKILLED NURSING FACILITY LICENSE