Healthcare Provider Details

I. General information

NPI: 1679146609
Provider Name (Legal Business Name): HILLCREST HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N SPRING ST
SEARCY AR
72143-7713
US

IV. Provider business mailing address

362 E KENNEDY BLVD
LAKEWOOD NJ
08701-1434
US

V. Phone/Fax

Practice location:
  • Phone: 501-254-0007
  • Fax: 888-866-9887
Mailing address:
  • Phone: 347-752-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHAIM HERZBERG
Title or Position: MEMBER
Credential:
Phone: 718-838-1500