Provider Demographics
NPI:1477037133
Name:HILLTOP HAVEN INC
Entity Type:Organization
Organization Name:HILLTOP HAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-942-9084
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-0035
Mailing Address - Country:US
Mailing Address - Phone:877-570-7970
Mailing Address - Fax:855-570-3738
Practice Address - Street 1:2018 IL ROUTE 173
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IL
Practice Address - Zip Code:60071-9628
Practice Address - Country:US
Practice Address - Phone:877-570-7970
Practice Address - Fax:855-570-3738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty