1760514616 NPI number — SPEECH AND LANGUAGE ASSOCIATES OF DAYTON, 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 1760514616 NPI number — SPEECH AND LANGUAGE ASSOCIATES OF DAYTON, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH AND LANGUAGE ASSOCIATES OF DAYTON, 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:
6
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:
1760514616
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5335 FAR HILLS AVENUE
Provider Second Line Business Mailing Address:
STE 205
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45429-2317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-886-4312
Provider Business Mailing Address Fax Number:
937-907-1713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5335 FAR HILLS AVENUE
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45429-2317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-886-4312
Provider Business Practice Location Address Fax Number:
937-907-1713
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GLASER
Authorized Official First Name:
MARY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
937-886-4312

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 654828 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0420155 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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