Provider Demographics
NPI:1093921819
Name:CENTER FOR SUCCESSFUL STUDENTS, INC.
Entity Type:Organization
Organization Name:CENTER FOR SUCCESSFUL STUDENTS, INC.
Other - Org Name:TREASURE COAST SPEECH AND LANGUAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:772-463-6623
Mailing Address - Street 1:1982 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3951
Mailing Address - Country:US
Mailing Address - Phone:772-463-6623
Mailing Address - Fax:772-463-6628
Practice Address - Street 1:1982 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3951
Practice Address - Country:US
Practice Address - Phone:772-463-6623
Practice Address - Fax:772-463-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty