Provider Demographics
NPI:1366575540
Name:HIDDEN PINES INVESTMENTS LLC
Entity type:Organization
Organization Name:HIDDEN PINES INVESTMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-528-5289
Mailing Address - Street 1:815 N. CLAIBORNE STREET
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663
Mailing Address - Country:US
Mailing Address - Phone:337-528-5289
Mailing Address - Fax:337-528-8973
Practice Address - Street 1:815 N CLAIBORNE ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-1101
Practice Address - Country:US
Practice Address - Phone:337-528-5289
Practice Address - Fax:337-528-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty