Provider Demographics
NPI:1326472739
Name:SPEAKING LIFE INCORPORATED
Entity Type:Organization
Organization Name:SPEAKING LIFE INCORPORATED
Other - Org Name:SPEAKING LIFE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-221-4010
Mailing Address - Street 1:6000 POPLAR AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3981
Mailing Address - Country:US
Mailing Address - Phone:901-221-4010
Mailing Address - Fax:901-221-4011
Practice Address - Street 1:8370 TWIN ANGEL CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3323
Practice Address - Country:US
Practice Address - Phone:901-221-4010
Practice Address - Fax:901-221-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006139Medicaid