MEDICARE: HILLVIEW NURSING HOME, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility	895	LA

General Provider Information

NPI Number	:	1649267915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLVIEW NURSING HOME, INC.

Provider Business Mailing Address
First Line	:	650 HOLT STREET
Second Line	:	P.O. BOX 667
City	:	BASTROP
State	:	LA
Zip	:	71220-0650
Country	:	US
Telephone Number	:	318-281-0322
Fax Number	:	318-281-3770

Provider Business Practice Location Address
First Line	:	650 HOLT STREET
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71220-0650
Country	:	US
Telephone Number	:	318-281-0322
Fax Number	:	318-281-3770

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DONNICE J. REYNOLDS
Credential	:
Telephone Number	:	318-281-0322

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/22/2020

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