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NPI Code Detail

MEDICARE: HILL CREEK ASSISTED LIVING LLC

MEDICARE: HILL CREEK ASSISTED LIVING 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
1310400000XAssisted Living Facility1104101VA

General Provider Information

NPI Number : 1629210711
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILL CREEK ASSISTED LIVING LLC
Provider Business Mailing Address
First Line : 305 HILL CREEK RD
Second Line :
City : RICHLANDS
State : VA
Zip : 24641-2016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 305 HILL CREEK RD
Second Line :
City : RICHLANDS
State : VA
Zip : 24641-2016
Country : US
Telephone Number : 276-963-2828
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. CARRIE E. CRUTCHFIELD
Credential : LPN/ADMINISTRATOR
Telephone Number : 276-963-2828
Provider Enumeration Date : 04/03/2009
Last Update Date : 04/03/2009

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Directions to “HILL CREEK ASSISTED LIVING LLC ” Practice Location

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