1417002726 NPI number — THE GIVING TREE-SPEECH, LANGUAGE & READING SVS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417002726 NPI number — THE GIVING TREE-SPEECH, LANGUAGE & READING SVS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE GIVING TREE-SPEECH, LANGUAGE & READING SVS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417002726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1805 SE 16TH AVE
Provider Second Line Business Mailing Address:
#103
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34471-4672
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-861-9191
Provider Business Mailing Address Fax Number:
352-861-9124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1805 SE 16TH AVE
Provider Second Line Business Practice Location Address:
#103
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34471-4672
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-861-9191
Provider Business Practice Location Address Fax Number:
352-861-9124
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MANTZ
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, CO-OWNER
Authorized Official Telephone Number:
352-861-9191

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SA 5967 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SZ 3988 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SA 6643 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 344828 . This is a "HE MELISSA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: S2409 . This is a "BCBS ALICIA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 229580 . This is a "HEALTHEASE GRP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: S2281 . This is a "BCBS NIKI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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