Provider Demographics
NPI:1285649129
Name:HILLTOP RECOVERY CENTER
Entity Type:Organization
Organization Name:HILLTOP RECOVERY CENTER
Other - Org Name:AMP-CEP GROUP HOMES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:410-902-0448
Mailing Address - Street 1:10207 JENSEN LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3700
Mailing Address - Country:US
Mailing Address - Phone:410-902-0448
Mailing Address - Fax:410-902-0309
Practice Address - Street 1:10207 JENSEN LN
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3700
Practice Address - Country:US
Practice Address - Phone:410-902-0448
Practice Address - Fax:410-902-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12058324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403992100Medicaid