Healthcare Provider Details

I. General information

NPI: 1265475164
Provider Name (Legal Business Name): HILLVIEW NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HOLT ST
BASTROP LA
71220-4061
US

IV. Provider business mailing address

650 HOLT ST
BASTROP LA
71220-4061
US

V. Phone/Fax

Practice location:
  • Phone: 318-281-0322
  • Fax: 318-281-3770
Mailing address:
  • Phone: 318-281-0322
  • Fax: 318-281-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number221
License Number StateLA

VIII. Authorized Official

Name: MS. DONNICE REYNOLDS
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-281-0322