Provider Demographics
NPI:1629403613
Name:HILL ADULT DAY CARE
Entity Type:Organization
Organization Name:HILL ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUSE AID
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:CNA/HHA
Authorized Official - Phone:817-557-1366
Mailing Address - Street 1:2936 ALYSON WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0428
Mailing Address - Country:US
Mailing Address - Phone:817-557-1366
Mailing Address - Fax:
Practice Address - Street 1:2936 ALYSON WAY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0428
Practice Address - Country:US
Practice Address - Phone:817-557-1366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA10975433320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities