Organization
HILLTOP HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN E THOMAS (ADMINISTRATOR)
(747) 888-3678
Entity
Organization
Contact information
Practice address
20550 AETNA ST., WOODLAND HILLS, CA 91367
(747) 888-3678
Mailing address
20550 AETNA ST, WOODLAND HILLS, CA 91367-5411
(747) 888-3678
(818) 304-8081
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
197607186
CA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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