Provider Demographics
NPI:1700398088
Name:HILLCREST CARE & REHAB, LLC
Entity Type:Organization
Organization Name:HILLCREST CARE & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-887-3811
Mailing Address - Street 1:1421 W 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71857-3342
Mailing Address - Country:US
Mailing Address - Phone:870-887-3811
Mailing Address - Fax:870-887-6019
Practice Address - Street 1:1421 W 2ND ST N
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AR
Practice Address - Zip Code:71857-3342
Practice Address - Country:US
Practice Address - Phone:870-887-3811
Practice Address - Fax:870-887-6019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLCREST CARE & REHAB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119698311Medicaid