1255570438 NPI number — TALKTIME SPEECH THERAPY, LLC

Table of content: (NPI 1255570438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255570438 NPI number — TALKTIME SPEECH THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TALKTIME SPEECH THERAPY, LLC
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:
1255570438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20397 ROUTE 19 STE 30
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRANBERRY TWP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16066-6102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
558-877-3328
Provider Business Mailing Address Fax Number:
724-734-3253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2620 CONSTITUTION BLVD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER FALLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15010-1278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-846-8255
Provider Business Practice Location Address Fax Number:
724-647-1232
Provider Enumeration Date:
02/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SHOPE
Authorized Official First Name:
AMY
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
724-846-8255

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1023741100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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