Provider Demographics
NPI:1225222763
Name:HIP-ENTERPRIZES LTD
Entity Type:Organization
Organization Name:HIP-ENTERPRIZES LTD
Other - Org Name:HUMAN INTERACTION PROGRAM
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL III
Authorized Official - Suffix:
Authorized Official - Credentials:PH,D
Authorized Official - Phone:405-447-6188
Mailing Address - Street 1:505 NE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5807
Mailing Address - Country:US
Mailing Address - Phone:405-447-6188
Mailing Address - Fax:405-735-5265
Practice Address - Street 1:505 NE 12TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5807
Practice Address - Country:US
Practice Address - Phone:405-447-6188
Practice Address - Fax:405-735-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty