Provider Demographics
NPI:1881887883
Name:THE HIP GROUP, LLC
Entity type:Organization
Organization Name:THE HIP GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ELLERT
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:520-494-2242
Mailing Address - Street 1:1201 N PINAL AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-3336
Mailing Address - Country:US
Mailing Address - Phone:520-494-2242
Mailing Address - Fax:866-675-2158
Practice Address - Street 1:1201 N PINAL AVE
Practice Address - Street 2:SUITE D
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-3336
Practice Address - Country:US
Practice Address - Phone:520-494-2242
Practice Address - Fax:866-675-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD5429237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty