Healthcare Provider Details

I. General information

NPI: 1912205899
Provider Name (Legal Business Name): HILLCREST HEALTHCARE COMMUNITIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 LAKE BROOK BLVD
KNOXVILLE TN
37909-1133
US

IV. Provider business mailing address

2820 LAKE BROOK BLVD
KNOXVILLE TN
37909-1133
US

V. Phone/Fax

Practice location:
  • Phone: 865-342-4306
  • Fax: 865-246-4054
Mailing address:
  • Phone: 865-342-4306
  • Fax: 865-246-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberACL0000000236
License Number StateTN

VIII. Authorized Official

Name: LESA DAY
Title or Position: CORPORATE COUNSEL
Credential:
Phone: 865-414-3695