Healthcare Provider Details

I. General information

NPI: 1861228538
Provider Name (Legal Business Name): HILLCREST COVE ASSISTED LIVING FACILITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 E HILLCREST ST
ALTAMONTE SPRINGS FL
32701-7834
US

IV. Provider business mailing address

413 E HILLCREST ST
ALTAMONTE SPRINGS FL
32701-7834
US

V. Phone/Fax

Practice location:
  • Phone: 301-651-4037
  • Fax: 321-972-2859
Mailing address:
  • Phone: 301-651-4037
  • Fax: 321-972-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NADINE MCDANIEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-651-4037