Provider Demographics
NPI:1003245960
Name:HILLTOP RECOVERY SERVICES
Entity Type:Organization
Organization Name:HILLTOP RECOVERY SERVICES
Other - Org Name:HILLTOP RECOVERY FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER-RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:RASII CSC NCAC
Authorized Official - Phone:707-274-8171
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-0316
Mailing Address - Country:US
Mailing Address - Phone:707-274-8171
Mailing Address - Fax:707-274-8327
Practice Address - Street 1:3937 FOOTHILL DR
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458
Practice Address - Country:US
Practice Address - Phone:707-274-8171
Practice Address - Fax:707-274-8327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170011CN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility