1548313315 NPI number — RIVER SPEECH AND EDUCATIONAL SERVICES, INC

Table of content: (NPI 1548313315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548313315 NPI number — RIVER SPEECH AND EDUCATIONAL SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIVER SPEECH AND EDUCATIONAL 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:
1548313315
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3390 SAXONBURG BLVD.
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
GLENSHAW
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-767-5967
Provider Business Mailing Address Fax Number:
412-767-5960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3390 SAXONBURG BLVD.
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
GLENSHAW
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-767-5967
Provider Business Practice Location Address Fax Number:
412-767-5960
Provider Enumeration Date:
01/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RIVER
Authorized Official First Name:
CHERIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER, AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
412-767-5967

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SL0006123L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1020417940002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: SL0006123L . This is a "SPEECH THERAPIST LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".