1326266842 NPI number — KESSLER SPEECH THERAPY SERVICES, INC.

Table of content: (NPI 1326266842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326266842 NPI number — KESSLER SPEECH THERAPY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KESSLER SPEECH THERAPY 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:
1326266842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5123
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CLOUD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56302-5123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2835 W SAINT GERMAIN ST
Provider Second Line Business Practice Location Address:
#300
Provider Business Practice Location Address City Name:
SAINT CLOUD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56301-6280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-215-5590
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KESSLER
Authorized Official First Name:
JODELL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, CEO
Authorized Official Telephone Number:
320-251-5590

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  5520 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4600206 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7985172 . This is a "AETNA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 4600206 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7005573 . This is a "PREFERRED ONE COMM HEALTH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1880044 . This is a "MAYO MANAGEMENT" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1A510KE . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1A510KE . This is a "BLUE PLUS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 645133 . This is a "PRO NET" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 9390635 . This is a "LUMENOS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01016518 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 115484 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7005573 . This is a "PREFERRED ONE ADMIN SERV" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1A510KE . This is a "BLUE LINK" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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