Healthcare Provider Details

I. General information

NPI: 1407702186
Provider Name (Legal Business Name): HILLTOP HIDEAWAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 HANOVER PIKE
HAMPSTEAD MD
21074-1145
US

IV. Provider business mailing address

2525 HANOVER PIKE
HAMPSTEAD MD
21074-1145
US

V. Phone/Fax

Practice location:
  • Phone: 443-948-0548
  • Fax:
Mailing address:
  • Phone: 443-948-0548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JULIAN QUARTERMAINE WRIGHT
Title or Position: PRESIDENT & CEO
Credential:
Phone: 443-948-0548