Provider Demographics
NPI:1578866323
Name:HILLTOP RECOVERY SERVICES
Entity Type:Organization
Organization Name:HILLTOP RECOVERY SERVICES
Other - Org Name:HILLTOP RECOVERY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER-RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII, CATC NCAC
Authorized Official - Phone:707-998-1800
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95423-0366
Mailing Address - Country:US
Mailing Address - Phone:707-998-1800
Mailing Address - Fax:707-998-0122
Practice Address - Street 1:14715 HIGHWAY 20
Practice Address - Street 2:14725 CATHOLIC CHURCH RD
Practice Address - City:CLEARLAKE OAKS
Practice Address - State:CA
Practice Address - Zip Code:95423-0366
Practice Address - Country:US
Practice Address - Phone:707-998-1800
Practice Address - Fax:707-998-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1700011AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility