Provider Demographics
NPI:1356882088
Name:HILLTOP WAY, LLC
Entity type:Organization
Organization Name:HILLTOP WAY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:JEWELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-545-7623
Mailing Address - Street 1:3813 VIA DEL CAMPO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2636
Mailing Address - Country:US
Mailing Address - Phone:949-545-7623
Mailing Address - Fax:949-545-7624
Practice Address - Street 1:3813 VIA DEL CAMPO
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2636
Practice Address - Country:US
Practice Address - Phone:949-545-7623
Practice Address - Fax:949-545-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300391BPOtherDEPARTMENT OF HEALTH CARE SERVICES
CA300391CPOtherDEPARTMENT OF HEALTH CARE SERVICES