MEDICARE: HILLCREST CARE & REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	692	AR

General Provider Information

NPI Number	:	1033295266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLCREST CARE & REHAB LLC

Provider Business Mailing Address
First Line	:	1421 WEST SECOND STREET NORTH
Second Line	:
City	:	PRESCOTT
State	:	AR
Zip	:	71857-3342
Country	:	US
Telephone Number	:	870-887-3811
Fax Number	:	870-887-6019

Provider Business Practice Location Address
First Line	:	1421 WEST SECOND STREET NORTH
Second Line	:
City	:	PRESCOTT
State	:	AR
Zip	:	71857-3342
Country	:	US
Telephone Number	:	870-887-3811
Fax Number	:	870-887-6019

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARGIE JOHNSON
Credential	:
Telephone Number	:	870-887-3811

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	08/22/2020

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