Provider Demographics
NPI:1457716367
Name:HILLTOP HEALTH SERVICES
Entity Type:Organization
Organization Name:HILLTOP HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:970-242-4400
Mailing Address - Street 1:1331 HERMOSA AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-4099
Mailing Address - Country:US
Mailing Address - Phone:970-244-4400
Mailing Address - Fax:970-263-2598
Practice Address - Street 1:1405 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8230
Practice Address - Country:US
Practice Address - Phone:970-245-3952
Practice Address - Fax:970-242-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO522116Medicaid