Vancrest of Hicksville LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VANCREST OF HICKSVILLE LLC

Doing business as

Vancrest of Hicksville Assisted Living

Practice address

601 Defiance Ave
Hicksville, OH 43526

Phone

(419) 542-7795

NPI assigned

Feb 6, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edgar Silalahi

Title

Cfo

Phone

(419) 238-0715

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Vancrest of Hicksville Assisted Living Doing business as

Tax ID family

Vancrest of Hicksville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vancrest of Hicksville LLC

  • Skilled Nursing Facility
  • Hicksville, OH
  • NPI 1851976658
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1821852385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 200",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911761",
            "telephone_number": "419-238-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DEFIANCE AVE",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "43526",
            "telephone_number": "419-542-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCREST OF HICKSVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "SILALAHI",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-238-0715"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCF",
            "identifier": "2985R",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072056",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vancrest of Hicksville Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brent Allen Roth, DC
• Julie P Siebenaler, CCC/SLP
• Nitie I Sroa, D.P.M.
• Crystal M. Trabel
• Trinity Hearing Care
• Vancrest of Hicksville LLC
• Village of Hicksville
• Michelle Vogelsong
• Vincent D Waldron, M.D.
• Desare R Wilhelm, LMT

• Assisted Living Facility in Hicksville, OH
• Providers in Hicksville, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.