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Organization
HILLCREST CONVALESCENT CENTER, INC.
Active
Organization
HILLCREST CONVALESCENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS TED SMITH NHA (ADMINISTRATOR)
(919) 286-7705
Entity
Organization
Contact information
Practice address
1417 W PETTIGREW ST, DURHAM, NC 27705-4820
(919) 286-7705
(919) 286-3772
Mailing address
1417 W PETTIGREW ST, DURHAM, NC 27705-4820
(919) 286-7705
(919) 286-3772
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
NH0038
NC
314000000X
Skilled Nursing Facility
Primary
NH0038
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3405001
SKILLED MEDICAID
NC
05
—
3496052
—
NC
Enumeration date
05/23/2005
Last updated
01/23/2020
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