Provider Demographics
NPI:1225242779
Name:INDEPENDENT SPEECH INC
Entity Type:Organization
Organization Name:INDEPENDENT SPEECH INC
Other - Org Name:KENTUCKY REHABILITATION GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT REHAB DIRECTORY
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP PRESIDENT
Authorized Official - Phone:270-566-0172
Mailing Address - Street 1:1831 OLD CLEAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642
Mailing Address - Country:US
Mailing Address - Phone:270-566-0172
Mailing Address - Fax:270-343-2978
Practice Address - Street 1:1831 OLD CLEAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642
Practice Address - Country:US
Practice Address - Phone:270-566-0172
Practice Address - Fax:270-343-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty