1851148209 NPI number — YOUR CORNER CHILDREN'S SPEECH AND LANGUAGE SERVICES, INC.

Table of content: DR. JACK DEE HOLLADA D.C. (NPI 1336148451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851148209 NPI number — YOUR CORNER CHILDREN'S SPEECH AND LANGUAGE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOUR CORNER CHILDREN'S SPEECH AND LANGUAGE SERVICES, 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:
1851148209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2312 CALUMET CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68502-4115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-217-5020
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2312 CALUMET CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68502-4115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-217-5020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2024

Additional Information

Authorized Official

Authorized Official Last Name:
BRADY
Authorized Official First Name:
BETH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT/SPEECH LANGUAGE PATHOLOGI
Authorized Official Telephone Number:
402-217-5020

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X ; 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)





Copyright © 2007-2025 www.npivalidator.com