Provider Demographics
NPI:1184855249
Name:ASTOR TRUST LLC
Entity Type:Organization
Organization Name:ASTOR TRUST LLC
Other - Org Name:THE CENTER FOR COMMUNICATION DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARFATI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:954-965-6924
Mailing Address - Street 1:1150 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4489
Mailing Address - Country:US
Mailing Address - Phone:954-965-6924
Mailing Address - Fax:954-454-5992
Practice Address - Street 1:1150 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4489
Practice Address - Country:US
Practice Address - Phone:954-965-6924
Practice Address - Fax:954-454-5992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty