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General NPI Number Information
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NPI Number | 1861725509
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Entity Type | Organization
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Legal Business Name | HILDEIR INC.
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 22737 BARTON RD SUITE 5
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5262
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Country | US
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Telephone | 909-370-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 22737 BARTON ROAD SUITE 5
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City | GRAND TERRACE
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State | CA
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Zip | 92313
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Country | US
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Telephone | 909-370-4250
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. JANET E HACKLEMAN
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Credential | RN, MFT
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Telephone | 909-370-4250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC 16132
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License Number State | CA
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