Provider Demographics
NPI:1225138316
Name:CLARKE SCHOOLS FOR HEARING AND SPEECH FLORIDA INC.
Entity Type:Organization
Organization Name:CLARKE SCHOOLS FOR HEARING AND SPEECH FLORIDA INC.
Other - Org Name:CLARKE SCHOOLS FOR HEARING AND SPEECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-584-3450
Mailing Address - Street 1:9803 OLD SAINT AUGUSTINE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8845
Mailing Address - Country:US
Mailing Address - Phone:413-582-1171
Mailing Address - Fax:413-586-0267
Practice Address - Street 1:9803 OLD SAINT AUGUSTINE RD STE 7
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8845
Practice Address - Country:US
Practice Address - Phone:413-582-1171
Practice Address - Fax:413-586-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885408400Medicaid