Provider Demographics
NPI:1912205899
Name:HILLCREST HEALTHCARE COMMUNITIES, INC
Entity Type:Organization
Organization Name:HILLCREST HEALTHCARE COMMUNITIES, INC
Other - Org Name:LAKEBROOK PLACE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-414-3695
Mailing Address - Street 1:2820 LAKE BROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1133
Mailing Address - Country:US
Mailing Address - Phone:865-342-4306
Mailing Address - Fax:865-246-4054
Practice Address - Street 1:2820 LAKE BROOK BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1133
Practice Address - Country:US
Practice Address - Phone:865-342-4306
Practice Address - Fax:865-246-4054
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLCREST HEALTHCARE COMMUNITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000236310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility