Provider Demographics
NPI:1467704924
Name:HIGHLAND ENTERPRISES LLC
Entity Type:Organization
Organization Name:HIGHLAND ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-865-7706
Mailing Address - Street 1:384 N 3RD AVE
Mailing Address - Street 2:STE D
Mailing Address - City:FRUITPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49415-9788
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3006 W SHORE DR
Practice Address - Street 2:STE 60
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-7508
Practice Address - Country:US
Practice Address - Phone:616-399-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty