HP Limited Dividend Housing Association LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

HP LIMITED DIVIDEND HOUSING ASSOCIATION LLC

Practice address

777 E Woodward Heights Blvd
Hazel Park, MI 48030-2700

Phone

(248) 545-0707

NPI assigned

May 12, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jillian Tisch

Title

Executive Director

Phone

(248) 545-0707

Specialties & licenses 2

Addresses

Other names 1

• Baldwin House Hazel Park Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1104448232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E WOODWARD HEIGHTS BLVD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480302700",
            "telephone_number": "248-545-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E WOODWARD HEIGHTS BLVD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480302700",
            "telephone_number": "248-545-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HP LIMITED DIVIDEND HOUSING ASSOCIATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "TISCH",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-545-0707"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baldwin House Hazel Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hazel Park Primary Care LLC
• Hazel Park Urgent Care PLLC
• Hazelwood Pharmacy LLC
• Gina Marie Hodgson
• Kathryn Hornick
• Emma Hubbard
• Godwin Ilonze
• Irwin Goodman
• Aisha Jackson- Tucker
• Jenna Nura Jackson, PA-C

• All providers in Hazel Park, MI
• Home Delivered Meals in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.