Healthcare Provider Details

I. General information

NPI: 1700758299
Provider Name (Legal Business Name): HIIPE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20200 GLEN RUSS LN
EUCLID OH
44117-2417
US

IV. Provider business mailing address

PO BOX 10554
CLEVELAND OH
44110-0554
US

V. Phone/Fax

Practice location:
  • Phone: 216-804-0044
  • Fax:
Mailing address:
  • Phone: 216-804-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TANISHA JORDAN
Title or Position: OWNER
Credential:
Phone: 216-804-0044