MEDICARE: HILL'S GROUP HOME INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility		AL

General Provider Information

NPI Number	:	1366595944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL'S GROUP HOME INC.

Provider Business Mailing Address
First Line	:	4388 HIGHPOINT BLVD
Second Line	:
City	:	EIGHT MILE
State	:	AL
Zip	:	36613-3719
Country	:	US
Telephone Number	:	251-604-6056
Fax Number	:	251-452-2197

Provider Business Practice Location Address
First Line	:	4388 HIGHPOINT BLVD
Second Line	:
City	:	EIGHT MILE
State	:	AL
Zip	:	36613-3719
Country	:	US
Telephone Number	:	251-604-6056
Fax Number	:	251-452-2197

Authorized Official
Title or Position	:	PROVIDER
Name	:	MRS. PAULA HILL
Credential	:
Telephone Number	:	251-478-7166

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	10/25/2007

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