Provider Demographics
NPI:1215022819
Name:SPEECH THERAPY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SPEECH THERAPY ASSOCIATES, INC.
Other - Org Name:SUNRISE REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GATESY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC
Authorized Official - Phone:517-339-5691
Mailing Address - Street 1:1660 HASLETT RD.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-9475
Mailing Address - Country:US
Mailing Address - Phone:517-339-5691
Mailing Address - Fax:517-339-5703
Practice Address - Street 1:1660 HASLETT RD.
Practice Address - Street 2:SUITE 6
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9475
Practice Address - Country:US
Practice Address - Phone:517-339-5691
Practice Address - Fax:517-339-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI234517AAMedicare ID - Type Unspecified