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General NPI Number Information
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NPI Number | 1962514380
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Entity Type | Organization
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Legal Business Name | HILLCREST NURSING HOME OF CORBIN, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1245 AMERICAN GREETING CARD RD
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City | CORBIN
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State | KY
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Zip | 40701-4811
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Country | US
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Telephone | 606-528-8917
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Fax | 606-528-0070
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Provider Business Mailing Address
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Address Line | PO BOX 556
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City | CORBIN
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State | KY
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Zip | 40702-0556
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Country | US
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Telephone | 606-528-8917
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Fax | 606-528-0070
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. TERRY EMANUEL FORCHT
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Credential |
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Telephone | 606-528-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 100425
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License Number State | KY
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