Hilltop Haven

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

197607186 Issued in CA

Legal business name

HILLTOP HAVEN

Practice address

20550 Aetna St.
Woodland Hills, CA 91367

Phone

(747) 888-3678

NPI assigned

Oct 7, 2015

Last updated

Oct 7, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Glen E Thomas

Title

Administrator

Phone

(747) 888-3678

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1831560572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20550 AETNA ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675411",
            "telephone_number": "747-888-3678",
            "fax_number": "818-304-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20550 AETNA ST.",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91367",
            "telephone_number": "747-888-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLTOP HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "747-888-3678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "197607186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.