Organization
VANCREST OF HICKSVILLE LLC
Active
Other names
Vancrest of Hicksville Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN WHITE (CEO)
(419) 238-0715
Entity
Organization
Contact information
Practice address
601 DEFIANCE AVE, HICKSVILLE, OH 43526
(419) 542-7795
Mailing address
120 W MAIN ST STE 200, VAN WERT, OH 45891-1761
(419) 238-0715
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072056
—
OH
01
—
2985R
RCF
OH
Enumeration date
02/06/2024
Last updated
10/15/2025
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