HILLTOP HOME INC. NPI 1902083975

NPI Information

NPI: 1902083975
Provider Name: HILLTOP HOME INC.

Former Legal Business Name: WAKE COUNTY SPECIALIZED RESIDENTIAL HOME FOR CHILDREN, INC.

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 34D2033798

Address:
2820 KIDD RD
RALEIGH, NC
ZIP 27610
Phone: (919) 231-8315
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HILLTOP HOME INC. is an intermediate care facility mentally retarded in Raleigh, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. HILLTOP HOME INC. NPI is 1902083975. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Wake County Specialized Residential Home For Children, Inc..

The provider's business location address is:

2820 KIDD RD
RALEIGH, NC
ZIP 27610-842
Phone: (919) 231-8315
Fax: (919) 861-0015

The provider's authorized official is Diane P. Van Husen .
The authorized official title is Executive Director and has the following contact phone number (919) 390-0045.

The CLIA number assigned to this NPI record is 34D2033798 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2008 and was last updated on 3/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		MHL-092-005	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3406020	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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