Healthcare Provider Details

I. General information

NPI: 1376523225
Provider Name (Legal Business Name): HILLCREST NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LAUCK DR
WINCHESTER VA
22603-4282
US

IV. Provider business mailing address

110 LAUCK DR
WINCHESTER VA
22603-4282
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-7830
  • Fax: 540-667-2941
Mailing address:
  • Phone: 540-667-7830
  • Fax: 540-667-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License NumberNH2589
License Number StateVA

VIII. Authorized Official

Name: DORIS M GARBER
Title or Position: ADMINISTRATOR
Credential: LCSW
Phone: 540-667-7830