Provider Demographics
NPI:1427019413
Name:HILLCREST HEALTHCARE COMMUNITIES, INC
Entity type:Organization
Organization Name:HILLCREST HEALTHCARE COMMUNITIES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUGATE-DAY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:865-414-3695
Mailing Address - Street 1:1758 HILLWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-573-9621
Mailing Address - Fax:865-246-4054
Practice Address - Street 1:1758 HILLWOOD DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2600
Practice Address - Country:US
Practice Address - Phone:865-573-9621
Practice Address - Fax:865-246-4054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN144313M00000X, 314000000X
TN0000000144313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445476Medicaid
TN7440207Medicaid
TN7440604Medicaid
TN000000144OtherNH LICENSE
TN0445476Medicaid