Healthcare Provider Details

I. General information

NPI: 1679357537
Provider Name (Legal Business Name): HILLVIEW SENIOR LIVING & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 N 11TH ST
VIENNA IL
62995-1522
US

IV. Provider business mailing address

35 S VINE ST
HARRISBURG IL
62946-1738
US

V. Phone/Fax

Practice location:
  • Phone: 618-658-2951
  • Fax:
Mailing address:
  • Phone: 182-948-6966
  • Fax: 618-294-8699

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: SCOTT STOUT
Title or Position: CEO/OWNER
Credential: LNHA
Phone: 618-294-8696