Provider Demographics
NPI:1053575423
Name:HILCREST RESIDENTIAL ALF
Entity type:Organization
Organization Name:HILCREST RESIDENTIAL ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SOLEDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-822-3582
Mailing Address - Street 1:220 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2916
Mailing Address - Country:US
Mailing Address - Phone:727-822-3582
Mailing Address - Fax:
Practice Address - Street 1:220 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2916
Practice Address - Country:US
Practice Address - Phone:727-822-3582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL5389310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility