Provider Demographics
NPI:1225521859
Name:HILLESLAND, INC.
Entity Type:Organization
Organization Name:HILLESLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILLESLAND
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:218-631-4966
Mailing Address - Street 1:223 JEFFERSON ST N
Mailing Address - Street 2:
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1370
Mailing Address - Country:US
Mailing Address - Phone:218-631-4966
Mailing Address - Fax:218-631-3801
Practice Address - Street 1:223 JEFFERSON ST N
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1370
Practice Address - Country:US
Practice Address - Phone:218-631-4966
Practice Address - Fax:218-631-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2213237600000X, 237700000X, 332S00000X
332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No332S00000XSuppliersHearing Aid Equipment