Provider Demographics
NPI:1861725509
Name:HILDEIR INC.
Entity type:Organization
Organization Name:HILDEIR INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:E
Authorized Official - Last Name:HACKLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MFT
Authorized Official - Phone:909-370-4250
Mailing Address - Street 1:22737 BARTON ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313
Mailing Address - Country:US
Mailing Address - Phone:909-370-4250
Mailing Address - Fax:
Practice Address - Street 1:22737 BARTON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5262
Practice Address - Country:US
Practice Address - Phone:909-370-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILDEIR INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 16132251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health