Healthcare Provider Details

I. General information

NPI: 1467675041
Provider Name (Legal Business Name): HILLCROFT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E STREETER AVE
MUNCIE IN
47303-1909
US

IV. Provider business mailing address

114 E STREETER AVE
MUNCIE IN
47303-1909
US

V. Phone/Fax

Practice location:
  • Phone: 765-284-4166
  • Fax: 765-287-9547
Mailing address:
  • Phone: 765-284-4166
  • Fax: 765-287-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33004807A
License Number StateIN

VIII. Authorized Official

Name: MRS. DEBBIE LYNNE BENNETT
Title or Position: CFO
Credential:
Phone: 765-284-4166