Provider Demographics
NPI:1043367139
Name:SPEECH HEARING & REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:SPEECH HEARING & REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-992-4433
Mailing Address - Street 1:2900 DONAHOE DR
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004
Mailing Address - Country:US
Mailing Address - Phone:440-992-4433
Mailing Address - Fax:440-992-6307
Practice Address - Street 1:2900 DONAHOE DR
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004
Practice Address - Country:US
Practice Address - Phone:440-992-4433
Practice Address - Fax:440-992-6307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268151Medicaid
OH366522Medicare ID - Type Unspecified