Provider Demographics
NPI:1255467866
Name:ENERGY ELECTRIC, INC
Entity Type:Organization
Organization Name:ENERGY ELECTRIC, INC
Other - Org Name:NORTH IDAHO SPEECH LANGUAGE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH PATHOLOGIST, OWNER,DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SLEYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MCSD CCC
Authorized Official - Phone:208-263-1843
Mailing Address - Street 1:724 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1654
Mailing Address - Country:US
Mailing Address - Phone:208-263-1843
Mailing Address - Fax:208-263-1843
Practice Address - Street 1:724 PINE ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1654
Practice Address - Country:US
Practice Address - Phone:208-263-1843
Practice Address - Fax:208-263-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID136521Medicare ID - Type Unspecified
ID324817Medicare UPIN
IDSP 28-4Medicare UPIN
ID000010007798Medicare UPIN
ID33646Medicare UPIN