# ATRIUM HILLCREST LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CCG-Lakeshore, Inc., Hillcrest Nursing and Rehabilitation Community
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518965698
- **Authorized official:** DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
- **Authorized official phone:** (614) 416-0600

## Contact information

- **Practice address:** 695 MITZI ST, NORTH MUSKEGON, MI 49445-3232
- **Practice address phone:** (231) 744-1641
- **Practice address fax:** (231) 744-9567
- **Mailing address:** 695 MITZI ST, NORTH MUSKEGON, MI 49445-3232
- **Mailing address phone:** (231) 744-1641
- **Mailing address fax:** (231) 744-9567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 61-4040 | MI | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 03/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09884 | BCBS PROVIDER CODE | MI |
| 05 | — | 60 2081901 | — | MI |