1932245610 NPI number — COMPREHENSIVE SPEECH THERAPY, LLC

Table of content: (NPI 1932245610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932245610 NPI number — COMPREHENSIVE SPEECH THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE 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:
1932245610
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6228 CREEKSIDE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70808-0118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-603-1933
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8762 QUARTERS LAKE RD
Provider Second Line Business Practice Location Address:
BLDG. 12 SUITE 5
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70809-7300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-603-1933
Provider Business Practice Location Address Fax Number:
225-757-7248
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STRANGE
Authorized Official First Name:
HOLLY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
225-603-1933

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: 4044 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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